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J Clinic Care Skill 2026, 7(1): 9-13 |
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Received: 2025/11/15 | Accepted: 2025/12/14 | Published: 2026/01/11
Received: 2025/11/15 | Accepted: 2025/12/14 | Published: 2026/01/11
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Hatamipour K, Salehi H, Bahmanpour R. Effect of Positive and Negative Meta-Emotions and Self-belief on Job Burnout in Nurses in Bojnord City. J Clinic Care Skill 2026; 7 (1) :9-13
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1- Department of Nursing, To.C. (Tonekabon Campus), Islamic Azad University, Tonekabon, Iran
2- Department of Psychology, To.C. (Tonekabon Campus), Islamic Azad University, Tonekabon, Iran
2- Department of Psychology, To.C. (Tonekabon Campus), Islamic Azad University, Tonekabon, Iran
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Introduction
Nurses play a key role in the healthcare system; yet, continuous occupational pressures threaten their psychological well-being [1]. They encounter a combination of emotional, physical, and organizational demands on a daily basis. These pressures arise within the context of constant interactions with patients, their families, and other members of the healthcare team, gradually placing nurses at risk of job burnout [2]. Whenever nurses’ psychological resources and capacities do not match the magnitude of their responsibilities and workplace demands, the likelihood of job burnout increases. This condition endangers both the personal health of nurses and the quality of care provided [3]. Reports indicate that the level of job burnout among Iranian nurses is estimated to be higher than the global average, highlighting the importance of identifying the psychological factors associated with it [4].
Job burnout is shaped by both individual characteristics and interpersonal relationships. One construct that has received increasing attention in recent years is meta-emotions. This construct refers to the attitudes, beliefs, and feelings individuals have about their own emotions, reflecting how they interpret, evaluate, and regulate them [5]. In the field of nursing, meta-emotions hold particular importance. Recent studies have shown that nurses who experience positive meta-emotions tend to demonstrate greater effectiveness in accepting emotions, engaging in measured emotional expression, and making sound clinical decisions [6]. In contrast, negative meta-emotions are associated with emotional suppression and heightened stress [7].
Self-belief is also an important parameter associated with nurses’ job performance and psychological well-being. This construct reflects how individuals perceive and accept their personal abilities, skills, and values, influencing their capacity to cope with pressures and persist in challenging conditions [8]. Individuals with low self-belief tend to feel less mastery over stressful situations and are more vulnerable to occupational difficulties [9, 10]. Professional self-belief is linked to nurses’ quality of performance and sense of responsibility; nurses with higher levels of self-belief are less prone to burnout when facing job-related stressors [11]. In clinical settings, nurses’ sense of responsibility and the quality of their clinical judgment are also associated with their level of self-belief [12].
A considerable portion of the existing research has examined meta-emotions or self-belief separately. In Iran, studies that simultaneously investigate these parameters in relation to job burnout among employed nurses are limited. Therefore, the present study was conducted to explain the role of positive and negative meta-emotions and self-belief in predicting nurses’ job burnout.
Instrument and Methods
This descriptive-correlational study was conducted on nurses working in hospitals in Bojnord in 2024, estimated at approximately 596 individuals. To determine the sample size, the Krejcie and Morgan formula was used; ultimately, considering the possibility of sample attrition, 250 nurses were selected through random sampling. Ultimately, due to attrition, data from 234 nurses were included in the final analysis.
The inclusion criteria were having at least five years of work experience, holding at least a bachelor’s degree, and not suffering from chronic diseases or severe psychological or behavioral disorders. The exclusion criteria included unwillingness to continue the study or incomplete questionnaires.
Three questionnaires were used in this study:
1. Self-Belief Scale: Developed by Chen et al. in 2001 [13], this scale consists of 8 items answered on a five-point Likert scale, ranging from strongly agree (5) to strongly disagree (1). Gholipour and Piran-Nejad, through exploratory and confirmatory factor analyses of the questionnaire, confirmed its validity and reported a Cronbach’s alpha of 0.86 [14]. In the present study, the reliability of the questionnaire, measured using Cronbach’s alpha, was 0.83.
2. Meta-Emotions Questionnaire: This questionnaire was developed by Mitmansgruber et al. and consists of 28 items, each rated on a six-point Likert scale ranging from completely true (6) to not true at all (1) [15]. Higher scores indicate a greater presence of the respective component in the individual. The questionnaire assesses both negative and positive meta-emotions: Negative meta-emotions include anger (items 3, 5, 15, and 27), shame (items 12, 14, 17, 20, and 21), aggression control (items 1, 6, 8, 19, and 26), and suppression (items 10 and 25); Positive meta-emotions include compassion (items 2, 4, 7, 9, 11, 22, and 24) and interest (items 13, 16, 18, 23, and 28). Rezaei et al., through factor analysis, confirmed the two main dimensions of positive and negative meta-emotions and reported a Cronbach’s alpha of 0.78 for the tool in Iran. Concurrent validity was also examined using an emotional intelligence questionnaire, showing a particularly favorable correlation between positive meta-emotions and components of emotional intelligence [16]. In the present study, the reliability of the questionnaire, assessed by Cronbach’s alpha, was 0.79 for positive meta-emotions and 0.81 for negative meta-emotions.
3. Maslach Burnout Inventory: This questionnaire was developed by Maslach & Jackson and consists of 22 items [17]. The items are scored on a five-point Likert scale ranging from strongly agree (1) to strongly disagree (5). Items 1, 2, 3, 5, 6, 8, 10, 11, 13, 14, 15, 16, 20, and 22 are reverse-scored. The questionnaire comprises three components: Emotional exhaustion, depersonalization, and reduced personal accomplishment. The minimum possible score is 22, and the maximum is 110. Item 23 measures overall job burnout. The psychometric properties of the questionnaire were assessed by Akbari et al. in Iran in 2011, and exploratory and confirmatory factor analyses confirmed the three-factor structure of the 22-item Maslach Burnout Inventory in Persian [18]. The reliability of the instrument for the three components—emotional exhaustion, depersonalization, and personal accomplishment—was reported as 0.76, 0.60, and 0.70, respectively.
Data collection was carried out after coordinating with hospital administrators and obtaining the necessary permissions. The researcher visited three hospitals (Imam Hassan, Imam Ali, and Imam Reza) following prior arrangements and, after explaining the research objectives and the questionnaire completion process, distributed the questionnaires among the participants.
To ensure ethical compliance, an introductory letter was obtained from the Islamic Azad University, Tonekabon Branch, and a permit was granted by the Bojnord University of Medical Sciences, with a formal ethical approval code issued. Informed consent was obtained from all participants, emphasizing the confidentiality of their information and their right to withdraw from the study at any time. Participants were assured that all data would remain confidential, that the information would be analyzed collectively, that the results of the study would be made available to them, and that their identities would not be disclosed in any documents related to the study or its publications.
Pearson correlation and regression analyses were conducted using SPSS 25 to examine the relationships between self-belief, positive and negative meta-emotions, and job burnout. To assess data normality, skewness and kurtosis tests were performed and none of the research parameters exhibited serious deviations from a normal distribution.
Findings
Among the female nurses, the largest percentages had 5 to 10 years of work experience (44%) and held a bachelor’s degree (71%). The mean score of burnout was 68.401±11.282, positive meta-emotion was 44.448±7.737, negative meta-emotion was 52.102±9.476, and self- belief was 78.423±10.784.
The Pearson correlation coefficients indicated a significant negative relationship between self-belief and burnout (p<0.05), suggesting that as self- belief increases, burnout decreases. Furthermore, there was a significant negative relationship between positive meta-emotion and burnout (p<0.05), and a significant positive relationship between negative meta-emotion and burnout (p<0.05).
After confirming the relationships between negative and positive meta-emotions and self- belief with burnout, a simultaneous multiple regression analysis was conducted to examine the predictive role of the independent parameters (positive and negative meta-emotions, and self-belief) on the dependent parameter (burnout).
The multiple regression analysis was performed to predict burnout based on positive and negative meta-emotions and self-belief. The sample size (n=234) was adequate, exceeding the minimum requirement. Data normality was previously verified, and the independence of residuals was confirmed by the Durbin-Watson statistic (1.532), which falls within the acceptable range. The results of the multiple regression analysis confirmed the model’s significance (F=15.552, p<0.001). Accordingly, positive meta-emotion, negative meta-emotion, and self-belief were significant predictors of burnout. Based on the obtained coefficient of determination (R²=0.169), positive meta-emotion, negative meta-emotion, and self-belief explained 16% of the variance in burnout.
Furthermore, positive meta-emotion had a significant negative contribution to predicting burnout. Negative meta-emotion demonstrated a significant positive unique contribution to burnout prediction, while self-belief exhibited a significant negative unique contribution to predicting burnout (Table 1).
Table 1. Regression coefficients for predicting burnout based on positive and negative meta-emotions and self-belief
Discussion
This study aimed to determine the role of positive and negative meta-emotions and self-belief in nurses’ job burnout. There was a significant relationship between positive and negative meta-emotions and job burnout. Specifically, an increase in positive meta-emotions was associated with a decrease in job burnout, while an increase in negative meta-emotions was associated with an increase in burnout. These findings are consistent with those of Heydarpour et al. [19], Gheybi & Zeinali [20], and Almardani Someeh et al. [21].
Meta-emotions, considered secondary emotions, are responses that arise in reaction to primary emotions and can manifest as either positive or negative. The positive and negative components of meta-emotions play a crucial role in individuals’ psychological well-being and their interactions with the surrounding environment [21]. According to the appraisal theory of emotions, these feelings emerge when individuals evaluate the impact of environmental factors on their goals, values, and needs [22].
Therefore, positive meta-emotions have a negative relationship with job burnout, whereas negative meta-emotions have a positive relationship with it. In other words, higher levels of positive meta-emotions, such as compassion and interest in work, reduce fatigue and the sense of monotony associated with the job. Conversely, higher levels of negative meta-emotions, such as anger and shame, lead to a loss of energy and enthusiasm, resulting in job burnout and feelings of tedium in performing professional tasks.
Self-belief had a significant negative relationship with job burnout. In other words, as the level of self-belief increases, the level of job burnout decreases. This finding is consistent with the studies by Low et al. [23], Sanavi Fard et al. [24], Karimi Nasab [25], Hamid et al. [26], Pereira-Lima & Loureiro [27], and Soleimannejad et al. [28]. Individuals with high self-belief can perform their duties more calmly and enjoy workplace interactions; this characteristic strengthens communication skills, enhances collaboration and participation, and reduces workplace stress. Moreover, self-belief influences an individual’s focus on goals and future performance, generating greater energy and motivation for work, which results in less fatigue and monotony.
In a study on the relationship between coworker and supervisor support, self-belief, coping skills, and job burnout among nursing staff in long-term care settings, coworker and supervisor support, self-belief, and adaptive coping each predict dimensions of job burnout (emotional exhaustion, depersonalization, and personal accomplishment) [23]. Self-belief is a strong independent predictor of job burnout because the way individuals value and perceive themselves, based on their beliefs, fosters positive emotions and enables them to approach their work with energy and enthusiasm, thereby reducing job burnout. In other words, higher levels of self-belief among nurses are associated with lower job burnout, as self-belief meta-emotions multiple aspects of an individual’s life.
According to Bandura’s self-efficacy theory, a sense of self-efficacy plays a key role in achieving goals, performing tasks, and overcoming challenges, as self-belief allows individuals to be authentic, enjoy their interactions, and maintain calmness. In individuals with high self-belief, deeper connections are formed, which improve workplace communication skills, enhance trust among staff, increase participation and collaboration, and reduce stress and job pressure, ultimately leading to reduced burnout [29]. Put differently, self-belief focuses individuals on their future performance [30]. The better individuals understand themselves, their beliefs, and their values, the more energy and enthusiasm they bring to their work, thus experiencing less fatigue, monotony, and job burnout.
The limitations of this study include the small size of the statistical population and the inability to control for certain confounding parameters, such as economic status, ethnic background, and birth order. The limited population and the need for caution when generalizing the results to other groups and communities also represent additional constraints of this research.
It is recommended that training programs be implemented to reduce job burnout among nurses and within hospital environments. Additionally, therapeutic programs focused on emotional and meta-emotional regulation could be more effective. Interventions aimed at enhancing self-belief, such as programs based on self-awareness and self-cognition, may also be highly beneficial. Providing training to reduce job burnout in nurses and hospital workplaces—including mindfulness exercises, practical activities to improve cognitive styles, and exercises related to communication skills and emotion regulation—can be particularly useful.
Conclusion
There is a strong relationship between positive and negative meta-emotions and self-belief and nurses’ job burnout.
Acknowledgments: This research is the result of a master’s thesis in psychology at the Islamic Azad University, Tonekabon Branch. We sincerely wish all participants in the study good health and express our heartfelt gratitude to everyone who assisted us in conducting this research.
Ethical Permissions: This research was approved by the Islamic Azad University, Tonekabon Branch (IR.IAU.TON.REC.1402.002).
Conflicts of Interests: The authors reported no conflicts of interests.
Authors' Contribution: Hatamipour Kh (First Author), Methodologist/Main Researcher (40%); Salehi H (Second Author), Introduction Writer/Statistical Analyst (40%); Bahmanpour R (Third Author), Discussion Writer (20%)
Funding/Support: This study did not receive any financial support.
Nurses play a key role in the healthcare system; yet, continuous occupational pressures threaten their psychological well-being [1]. They encounter a combination of emotional, physical, and organizational demands on a daily basis. These pressures arise within the context of constant interactions with patients, their families, and other members of the healthcare team, gradually placing nurses at risk of job burnout [2]. Whenever nurses’ psychological resources and capacities do not match the magnitude of their responsibilities and workplace demands, the likelihood of job burnout increases. This condition endangers both the personal health of nurses and the quality of care provided [3]. Reports indicate that the level of job burnout among Iranian nurses is estimated to be higher than the global average, highlighting the importance of identifying the psychological factors associated with it [4].
Job burnout is shaped by both individual characteristics and interpersonal relationships. One construct that has received increasing attention in recent years is meta-emotions. This construct refers to the attitudes, beliefs, and feelings individuals have about their own emotions, reflecting how they interpret, evaluate, and regulate them [5]. In the field of nursing, meta-emotions hold particular importance. Recent studies have shown that nurses who experience positive meta-emotions tend to demonstrate greater effectiveness in accepting emotions, engaging in measured emotional expression, and making sound clinical decisions [6]. In contrast, negative meta-emotions are associated with emotional suppression and heightened stress [7].
Self-belief is also an important parameter associated with nurses’ job performance and psychological well-being. This construct reflects how individuals perceive and accept their personal abilities, skills, and values, influencing their capacity to cope with pressures and persist in challenging conditions [8]. Individuals with low self-belief tend to feel less mastery over stressful situations and are more vulnerable to occupational difficulties [9, 10]. Professional self-belief is linked to nurses’ quality of performance and sense of responsibility; nurses with higher levels of self-belief are less prone to burnout when facing job-related stressors [11]. In clinical settings, nurses’ sense of responsibility and the quality of their clinical judgment are also associated with their level of self-belief [12].
A considerable portion of the existing research has examined meta-emotions or self-belief separately. In Iran, studies that simultaneously investigate these parameters in relation to job burnout among employed nurses are limited. Therefore, the present study was conducted to explain the role of positive and negative meta-emotions and self-belief in predicting nurses’ job burnout.
Instrument and Methods
This descriptive-correlational study was conducted on nurses working in hospitals in Bojnord in 2024, estimated at approximately 596 individuals. To determine the sample size, the Krejcie and Morgan formula was used; ultimately, considering the possibility of sample attrition, 250 nurses were selected through random sampling. Ultimately, due to attrition, data from 234 nurses were included in the final analysis.
The inclusion criteria were having at least five years of work experience, holding at least a bachelor’s degree, and not suffering from chronic diseases or severe psychological or behavioral disorders. The exclusion criteria included unwillingness to continue the study or incomplete questionnaires.
Three questionnaires were used in this study:
1. Self-Belief Scale: Developed by Chen et al. in 2001 [13], this scale consists of 8 items answered on a five-point Likert scale, ranging from strongly agree (5) to strongly disagree (1). Gholipour and Piran-Nejad, through exploratory and confirmatory factor analyses of the questionnaire, confirmed its validity and reported a Cronbach’s alpha of 0.86 [14]. In the present study, the reliability of the questionnaire, measured using Cronbach’s alpha, was 0.83.
2. Meta-Emotions Questionnaire: This questionnaire was developed by Mitmansgruber et al. and consists of 28 items, each rated on a six-point Likert scale ranging from completely true (6) to not true at all (1) [15]. Higher scores indicate a greater presence of the respective component in the individual. The questionnaire assesses both negative and positive meta-emotions: Negative meta-emotions include anger (items 3, 5, 15, and 27), shame (items 12, 14, 17, 20, and 21), aggression control (items 1, 6, 8, 19, and 26), and suppression (items 10 and 25); Positive meta-emotions include compassion (items 2, 4, 7, 9, 11, 22, and 24) and interest (items 13, 16, 18, 23, and 28). Rezaei et al., through factor analysis, confirmed the two main dimensions of positive and negative meta-emotions and reported a Cronbach’s alpha of 0.78 for the tool in Iran. Concurrent validity was also examined using an emotional intelligence questionnaire, showing a particularly favorable correlation between positive meta-emotions and components of emotional intelligence [16]. In the present study, the reliability of the questionnaire, assessed by Cronbach’s alpha, was 0.79 for positive meta-emotions and 0.81 for negative meta-emotions.
3. Maslach Burnout Inventory: This questionnaire was developed by Maslach & Jackson and consists of 22 items [17]. The items are scored on a five-point Likert scale ranging from strongly agree (1) to strongly disagree (5). Items 1, 2, 3, 5, 6, 8, 10, 11, 13, 14, 15, 16, 20, and 22 are reverse-scored. The questionnaire comprises three components: Emotional exhaustion, depersonalization, and reduced personal accomplishment. The minimum possible score is 22, and the maximum is 110. Item 23 measures overall job burnout. The psychometric properties of the questionnaire were assessed by Akbari et al. in Iran in 2011, and exploratory and confirmatory factor analyses confirmed the three-factor structure of the 22-item Maslach Burnout Inventory in Persian [18]. The reliability of the instrument for the three components—emotional exhaustion, depersonalization, and personal accomplishment—was reported as 0.76, 0.60, and 0.70, respectively.
Data collection was carried out after coordinating with hospital administrators and obtaining the necessary permissions. The researcher visited three hospitals (Imam Hassan, Imam Ali, and Imam Reza) following prior arrangements and, after explaining the research objectives and the questionnaire completion process, distributed the questionnaires among the participants.
To ensure ethical compliance, an introductory letter was obtained from the Islamic Azad University, Tonekabon Branch, and a permit was granted by the Bojnord University of Medical Sciences, with a formal ethical approval code issued. Informed consent was obtained from all participants, emphasizing the confidentiality of their information and their right to withdraw from the study at any time. Participants were assured that all data would remain confidential, that the information would be analyzed collectively, that the results of the study would be made available to them, and that their identities would not be disclosed in any documents related to the study or its publications.
Pearson correlation and regression analyses were conducted using SPSS 25 to examine the relationships between self-belief, positive and negative meta-emotions, and job burnout. To assess data normality, skewness and kurtosis tests were performed and none of the research parameters exhibited serious deviations from a normal distribution.
Findings
Among the female nurses, the largest percentages had 5 to 10 years of work experience (44%) and held a bachelor’s degree (71%). The mean score of burnout was 68.401±11.282, positive meta-emotion was 44.448±7.737, negative meta-emotion was 52.102±9.476, and self- belief was 78.423±10.784.
The Pearson correlation coefficients indicated a significant negative relationship between self-belief and burnout (p<0.05), suggesting that as self- belief increases, burnout decreases. Furthermore, there was a significant negative relationship between positive meta-emotion and burnout (p<0.05), and a significant positive relationship between negative meta-emotion and burnout (p<0.05).
After confirming the relationships between negative and positive meta-emotions and self- belief with burnout, a simultaneous multiple regression analysis was conducted to examine the predictive role of the independent parameters (positive and negative meta-emotions, and self-belief) on the dependent parameter (burnout).
The multiple regression analysis was performed to predict burnout based on positive and negative meta-emotions and self-belief. The sample size (n=234) was adequate, exceeding the minimum requirement. Data normality was previously verified, and the independence of residuals was confirmed by the Durbin-Watson statistic (1.532), which falls within the acceptable range. The results of the multiple regression analysis confirmed the model’s significance (F=15.552, p<0.001). Accordingly, positive meta-emotion, negative meta-emotion, and self-belief were significant predictors of burnout. Based on the obtained coefficient of determination (R²=0.169), positive meta-emotion, negative meta-emotion, and self-belief explained 16% of the variance in burnout.
Furthermore, positive meta-emotion had a significant negative contribution to predicting burnout. Negative meta-emotion demonstrated a significant positive unique contribution to burnout prediction, while self-belief exhibited a significant negative unique contribution to predicting burnout (Table 1).
Table 1. Regression coefficients for predicting burnout based on positive and negative meta-emotions and self-belief
Discussion
This study aimed to determine the role of positive and negative meta-emotions and self-belief in nurses’ job burnout. There was a significant relationship between positive and negative meta-emotions and job burnout. Specifically, an increase in positive meta-emotions was associated with a decrease in job burnout, while an increase in negative meta-emotions was associated with an increase in burnout. These findings are consistent with those of Heydarpour et al. [19], Gheybi & Zeinali [20], and Almardani Someeh et al. [21].
Meta-emotions, considered secondary emotions, are responses that arise in reaction to primary emotions and can manifest as either positive or negative. The positive and negative components of meta-emotions play a crucial role in individuals’ psychological well-being and their interactions with the surrounding environment [21]. According to the appraisal theory of emotions, these feelings emerge when individuals evaluate the impact of environmental factors on their goals, values, and needs [22].
Therefore, positive meta-emotions have a negative relationship with job burnout, whereas negative meta-emotions have a positive relationship with it. In other words, higher levels of positive meta-emotions, such as compassion and interest in work, reduce fatigue and the sense of monotony associated with the job. Conversely, higher levels of negative meta-emotions, such as anger and shame, lead to a loss of energy and enthusiasm, resulting in job burnout and feelings of tedium in performing professional tasks.
Self-belief had a significant negative relationship with job burnout. In other words, as the level of self-belief increases, the level of job burnout decreases. This finding is consistent with the studies by Low et al. [23], Sanavi Fard et al. [24], Karimi Nasab [25], Hamid et al. [26], Pereira-Lima & Loureiro [27], and Soleimannejad et al. [28]. Individuals with high self-belief can perform their duties more calmly and enjoy workplace interactions; this characteristic strengthens communication skills, enhances collaboration and participation, and reduces workplace stress. Moreover, self-belief influences an individual’s focus on goals and future performance, generating greater energy and motivation for work, which results in less fatigue and monotony.
In a study on the relationship between coworker and supervisor support, self-belief, coping skills, and job burnout among nursing staff in long-term care settings, coworker and supervisor support, self-belief, and adaptive coping each predict dimensions of job burnout (emotional exhaustion, depersonalization, and personal accomplishment) [23]. Self-belief is a strong independent predictor of job burnout because the way individuals value and perceive themselves, based on their beliefs, fosters positive emotions and enables them to approach their work with energy and enthusiasm, thereby reducing job burnout. In other words, higher levels of self-belief among nurses are associated with lower job burnout, as self-belief meta-emotions multiple aspects of an individual’s life.
According to Bandura’s self-efficacy theory, a sense of self-efficacy plays a key role in achieving goals, performing tasks, and overcoming challenges, as self-belief allows individuals to be authentic, enjoy their interactions, and maintain calmness. In individuals with high self-belief, deeper connections are formed, which improve workplace communication skills, enhance trust among staff, increase participation and collaboration, and reduce stress and job pressure, ultimately leading to reduced burnout [29]. Put differently, self-belief focuses individuals on their future performance [30]. The better individuals understand themselves, their beliefs, and their values, the more energy and enthusiasm they bring to their work, thus experiencing less fatigue, monotony, and job burnout.
The limitations of this study include the small size of the statistical population and the inability to control for certain confounding parameters, such as economic status, ethnic background, and birth order. The limited population and the need for caution when generalizing the results to other groups and communities also represent additional constraints of this research.
It is recommended that training programs be implemented to reduce job burnout among nurses and within hospital environments. Additionally, therapeutic programs focused on emotional and meta-emotional regulation could be more effective. Interventions aimed at enhancing self-belief, such as programs based on self-awareness and self-cognition, may also be highly beneficial. Providing training to reduce job burnout in nurses and hospital workplaces—including mindfulness exercises, practical activities to improve cognitive styles, and exercises related to communication skills and emotion regulation—can be particularly useful.
Conclusion
There is a strong relationship between positive and negative meta-emotions and self-belief and nurses’ job burnout.
Acknowledgments: This research is the result of a master’s thesis in psychology at the Islamic Azad University, Tonekabon Branch. We sincerely wish all participants in the study good health and express our heartfelt gratitude to everyone who assisted us in conducting this research.
Ethical Permissions: This research was approved by the Islamic Azad University, Tonekabon Branch (IR.IAU.TON.REC.1402.002).
Conflicts of Interests: The authors reported no conflicts of interests.
Authors' Contribution: Hatamipour Kh (First Author), Methodologist/Main Researcher (40%); Salehi H (Second Author), Introduction Writer/Statistical Analyst (40%); Bahmanpour R (Third Author), Discussion Writer (20%)
Funding/Support: This study did not receive any financial support.
Keywords:
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