Journal of Critical Care Nursing
Year:2010 | Volume:3 | Issue:1|Papers Count:11

Aims: As the ultimate goal of professional nursing is to provide high quality care for patients in all fields (biological, psychological and social), nursing educators should use teaching methods that prevents superficial learning of students and improve meaningful and high level learning in them. The aim of this study was to compare the effect of lecture- and concept mapping based learning on cognitive learning levels of nursing students.Methods: In a quasi-experimental study with pre- and post-test method, 66 fifth semester nursing students in “Cardiovascular” course were selected by census method and randomly divided into two control and case groups. After performing pre-test, control and case groups received education using lecture and concept mapping, respectively, for 8 sessions during 2 months. Then, the post-test was taken and 4 weeks after, remind test was performed. For gathering data, a research-made educational improvement test consisted of two parts was used. Data was analyzed by repeated measurement ANOVA method and SPSS 15 software.Results: The procedure of total scores change (knowledge and learning level) was statistically significant in each of two methods (p<0.01). The procedure of knowledge scores change was not significant between two groups. But the procedure of scores change in meaningful learning level in case group was statistically significant (p<0.005).Conclusion: Concept mapping method is more effective to access meaningful learning and high levels of understanding than lecture method.

Aims: Nurse-patient interaction in health-treatment systems, especially emergent wards, is very important. This study investigated the effectiveness of nurse-patient communication in reducing emotional states (stress, anxiety and depression) in emergency department patients.Methods: This quasi-experimental study performed in one of the Tehran city hospitals’ emergency ward during June to December 2008. The study populations were of all patients who were admitted at the emergency department and hospitalized for at least, 3 hours. Two study and control groups (each 150 patients) were selected by available sampling method. Study group patients were cared by nurses trained about how to communicate with patients. Control group nurses were not under such training. To collect data, demographic and 21-questioned depression, anxiety and stress scale questionnaire were used. Data was analyzed by using SPSS 13 software and chi square, Man-Whitney and independent T tests.Results: 20.7% of control patients had severe depression, 24.6% had severed anxiety and 41.3% had severe stress. In study group, 22.1% of patients had severe depression, 20.3% had severed anxiety and 35.6% had severe stress. Differences were not significant between two groups in any fields (p>0.05).Conclusion: In general, stress, anxiety and depression level is high in emergency patients.Implementation of "to communicate effectively with patients" protocol by nurses does not significantly reduce depression, stress and anxiety of patients.

Aims: Sleep disorder is associated with several physical, behavioral and psychological problems. There are some evidences on disturbance of sleep quality in hemodialysis patients. For this, the present study was to evaluate the effect of applying continuous care model on sleep quality of hemodialysis patients.Methods: This semi-experimental study was performed on hemodialysis patients of Goldis hospital of Shahin Shahr during 2008 and 2009. 43 patients selected by census sampling method as study samples.Data gathering was done by Pittsburg sleep quality questionnaire. The applied model contained four steps (orientation, sensitization, control and evaluation). Patients were divided into five groups and 4-6 training sessions during three weeks were held for each group. During the next 9 weeks, consultations for continuous sleep monitoring, control and evaluation were performed. Immediately after the intervention and one month later, questionnaires were filled out again. Data were analyzed through SPSS 15 and by using descriptive and analytic statistics.Results: According to that in Pittsburg questionnaire the less score shows the better situation, the mean score of sleep quality before the intervention (10.39±3.64) was significantly (p<0.0001) more than that before the intervention (5.54±2.87). Also, sufficient sleep was seen in 17.4% of patients before the intervention that was increased significantly (p=0.0001) to 55% after the intervention.Conclusion: Performing the continuous care model has positive effect on sleep quality of hemodialysis patients. Training nurses in using this model can affect the improvement of sleep quality of hemodialysis patients.

Aims: In renal replacement therapies, increaseing the life expectancy and keeping health is not the only goal, rather it involves keeping and increasing quality of life. The aim of this study was to measure and compare the quality of life in renal transplantation and haemodialysis patients.Methods: This descriptive-analytical study performed on renal transplantation and haemodialysis patients reffered to one of the Tehran city hospitals in 2008. 76 haemodialysis and renal transplantation patients were selected by purposeful sampling method. For data collection, demographic and SF-36 questionnaires were used. Data was analyzed by SPSS 15 software and paired T-test and ANOVA with repeated measures methods.Results: Economic, family and job satisfaction (1=very satisfied; 5=very unsatisfied) for haemodialysis patients were 3.2 (relative satisfied), 2.34 (satisfied) and 1.36 (very satisfied) and for transplantation patients were 2.75 (relative satisfied), 2 (satisfied) and 3.10 (very satisfied), respectively. Two groups had significant differences in quality of life in general health (p=0.004) and physical health (p=0.01).Conclusion: Transplantation patients with higher score in quality of life in general health and physical health have better life than haemodialysis patients.

Aims: Excellence in pain assessment is crucial for pain management. Pain is a subjective and individual phenomenon and patients' assessment can be affected by their experiences. The purpose of this study was to compare the pain assessment of patients and triage nurses of emergency ward.Methods: This descriptive cross-sectional study performed on patients referred to 5-e-Azar hospital of Gorgan in 2007 and 16 nurses of triage area in emergency ward. 100 patients selected by purposive sampling method. Data was collected by a questionnaire of demographic information and numeric rating scale (NRS) of pain. At first, the triage nurse was rated the patient's pain based on history taking.Separately, researchers asked patients to rate their pain intensity in triage. Gathered data were analyzed by using Wilcoxon and Spearman correlation coefficient in SPSS 16 software.Results: The minimum patients' pain intensity score was 5. 90% of patients assessed their pain as severe.By increasing the estimate of patients from their pain, the nurses reported less pain and vice versa, when the patients estimated less pain, the nurses estimated it more. Patients' average pain intensity score was 9.13±1.26 and triage nurses' ratings were significantly lower (7.60±2.1; p<0.001).Conclusion: Estimation of patients and triage nurses from pain is inconsistent and in many cases, contrary to one another.

Aims: Coronary artery diseases are the most common cause of mortality. Risk factors have role in increasing incidence of coronary artery disease that can contribute to geographical location, living habits, culture, etc. This study was to evaluate the risk factors of coronary artery disease in Kerman city.Methods: This cross-sectional study performed on 400 of the population above 20 years in Kerman in 1383 That were selected randomly. A researcher-made questionnaire and a check-list were used to collecting data. After measuring weight, height and blood pressure in the place where samples live, introducing letter was given to them measuring blood sugar, cholesterol and triglyceride and lifestyle data were recorded by interview. Data was analyzed by Chi square, T-paired and ANOVA.Results: The prevalence of hypercholesterolemia was 25.8%, hypertriglyceridemia was 14%, hyperglycemia was 7.8%, systolic hypertension was 23.8% and diastolic hypertension was 24%. The average body mass index was 26.6±4.774 kg/m2. 46% of subjects had BMI above 27 kg/m2. The highest percentage of cholesterol, triglyceride and blood sugar were associated with age above 50 and married groups.Conclusion: Cholesterol, triglyceride and body mass index have significant positive correlation with all risk factors for coronary artery disease.

Aims: Fatigue is a common complaint and debilitating symptom in dialysis patients that has a considerable effect on quality of life and well being. The purpose of this study was measurement of fatigue and its related factors in patients with chronic renal failure receiving hemodialysis.Methods: This descriptive correlation study performed in one of the Medical Universities of Tehran in 2009. 56 hemodialysis patients were selected by simple achievable sampling method. Data was collected by fatigue severity scale (FSS) and personal information questionnaires included demographic, disease information and paraclinical findings. Data was analyzed by SPSS 14 software and paired T-test and ANOVA.Results: The fatigue score mean of the patients was 5.1. Women, widow and people without job reported higher fatigue. By reducing the level of education and income and increasing the age, dialysis history and risk of chronic renal failure the fatigue increased; these differences were significant only in terms of gender, income and history of chronic renal failure. Mean of fatigue was insignificantly decreased in patients with hemoglobin equal to 12-14 gr/dl, systolic blood pressure >160 mmHg, urea <30 and creatinine 6-8 mgr⁄dl.Conclusion: Most hemodialysis patients suffer from high scores of fatigue. In order to improve patient care and promote patients quality of life, nurses should identify fatigue, high risk patients and strategies for decrease it.

Aims: In order to review and determine the level and amount of relaxation, a standard scale is needed.According to that in Iran, there is so far no measure of relaxation made native or they are just translated, the aim of this study was to confirm the validity and reliability of Ramsy sedation scale in adult patients hospitalized in critical care units of Iran.Methods: This study is methodological. After translating the English version of Ramsy scale to Persian, 120 patients hospitalized in critical care units of two hospitals of Tehran city were selected by nonprobable accessible purposeful sampling method. Eight evaluators (Main researcher, six nurses and anesthesia resident) independently evaluated the patients by using Persian version of Ramsy scale.Patients evaluated at first by main researcher and then other investigators observed and independently recorded Glasgow modificated by Palma & Cook and Glasgow Coma scores for visual analog scale and a score for Ramsy scale.Results: Interclass correlation coefficient in trained group was 0.843 and the weighted kappa score for inter-rater agreement was 0.875 (p<0.001). Validity tests showed a high correlation (r=0.978) between Ramsy with visual analog scale and Glasgow Coma (r=0.772; p<0.001).Conclusion: Validity and reliability of Ramsy scale are confirmed for assessing sedation in adult patients hospitalized in critical care units in Iran.