Journal of Critical Care Nursing
Year:2011 | Volume:3 | Issue:4|Papers Count:10

Introduction: To encounter with problems due to the disease and treatment, chronic renal failure (CRF) patients use advocacy various resources for adjustment. A few studies exist about this problem, especially in Iranian society hemodialysis patients. This study was performed to explain perception of CRF patients from advocacy resources in adjustment with hemodialysis.Methods: This study was conducted with qualitative research approach and content analysis method in 2009. The participants were 16 hemodialysis patients in hemodialysis ward of Semnan University of Medical Sciences hospitals. Purposive sampling began and continued up to data saturation. Unstructured interview was the main method for data collection. The data were analyzed using qualitative content analysis method and constant comparative method.Results: In content analysis process, finally 6 themes emerged that indicated nature and dimensions of patients’ perception from advocacy resources. These themes included 1.joining the family members, 2.informed trust and hopefulness to physician, 3.nurses’ empathy and responsible accountability, 4.to be encouraged with adjusted and transplanted patients, 5.feeling worthy with friends’ companionship, 6.assurance and satisfaction with advocacy organizations.Conclusion: These results can help the managers and planners of health field to facilitate the adjustment of the new patients so that in what fields and aims they must focus and plan.

Introduction: Improving critical thinking is one of the most important objectives in nursing education. This study was performed to investigate the effect of concept mapping on critical thinking skills of the nursing students.Methods: This quasi-experimental study was done with two groups design, and pre-test post-test method in 2009.66 5th semester nursing students were selected through census method and randomly divided into two intervention and control groups. Control and intervention groups received education using lecture method and concept mapping, respectively, for 8 sessions during 2 months. The statistical analysis was done by software SPSS 15. Descriptive statistics, independent t-test, chi-square and ANOVA were used.Results: Performing concept mapping led to a significant increase in critical thinking skills scores in all domains except analysis domain (p=0.286) and deductive reasoning domain (p=0.104) in the intervention group in comparison with the control group. In spite of the significant increase in the mean score of critical thinking of the intervention group, comparing the mean difference of pre and post tests in the two groups (p=0.053), only analysis domain showed no significant difference.Conclusion: Using concept mapping in the education of nursing students may lead to develop critical thinking skills as one of the important duties of higher education.

Introduction: Lack of pain relief in patients, particularly in patients undergoing artery transplant surgery, cause higher mortality and complications. This study aimed to identify the opinions of the nurses about barriers of using of pain relief methods.Methods: In this descriptive study was done with 211 samples by census method in Kerman hospitals in 2008. For collecting the data, a researcher made questionnaire was used which had two parts (the first part was about demographic characteristics and the second part included 31 questions about barriers in four domains: patient, nurse, institution and physician). Analyzing the data was done by non-parametric tests (Mann-Whitney and Kruskal Wallis).Results: In nurses’ view, most barriers mentioned in patient’s area were not considered as barrier. Among the barriers to nurses, the most effective barrier was nurse inadequate knowledge about methods of nonpharmacologic pain relief (91.7 percent). The most effective barrier in the organizational area was hard prevent regulations in the use of opium drugs (52.2 percent) and in the physician’s area, lack of physician willingness to use of pain relief methods were charged the highest barrier (65.9 percent).Conclusion: Identifying pain relief barriers would help in overcoming these barriers and besides revising the difficult regulations on the use of narcotic drugs, seems necessary.

Introduction: In patients with chronic heart failure, balance abnormalities of the serum sodium and potassium levels and renal dysfunction commonly occurs. This study aimed to determine the amount of electrolyte abnormalities and renal dysfunction in elderly patients with systolic heart failure.Methods: This was a descriptive-analytical study. The study population included all the hospitalized patients who diagnosed with heart failure. The 154 patients who had the inclusion criteria were selected using census method during 2003 to 2008. The data analyzed using descriptive-analytical statistical method.Results: The elderly patients had 34.4% creatinine level of more than 1.5 mg/dl, 16.2% hyponatermia and 9.1% hyperkalemia. Serum creatinine level was associated with hospitalization duration (p=0.002), sex (p=0.041), liver cirrhosis (p=0.004) and mortality (p=0.000). Serum potassium level was associated with creatinine level (p=0.35), systolic blood pressure (p=0.042), diastolic blood pressure (p=0.046), number of comorbidities (p=0.044), CVA (cerebrovascular accidents) (p=0.001), taking diuretics (p=0.006), and angiotensin converting enzyme inhibitors (ACEI) (p=0.041). Serum sodium level was associated with comorbidities (p=0.034).Conclusion: The present study showed that the clinical status of elderly patients with systolic heart failure was poor based on the hemodynamic status, electrolyte balance and renal condition.

Introduction: Hospital triage is part of the emergency department structure which is done by emergency nurses. There is a little information about knowledge level of the nurses about triage. This study aimed to determine knowledge level of the nurses about hospital triage.Methods: This was the descriptive survey using simple random sampling. The researcher made questionnaire included 25 questions in three parts of demographic data, pure triage knowledge (15 questions) and triage decision making (10 questions). Seventy nurses of the emergency department participated in the study from all the hospitals of Sistan-Baluchestan province in 2009. The reliability of the questionnaire obtained 0.60 using test-retest. The data were analyzed using Kappa statistics, independent t-test, Pearson correlation coefficients through software SPSS15.Results: The response rate was equal to 68% (70 out of 102). The nurses had not enough knowledge about the hospital triage, 39.94% of the responses to the knowledge level questions were correct. Only in 3 hospitals (out of 10), special nurses have been dedicated to triage. The nurses who had more than two years experience in emergency department had received a higher average score. The concordance rate of the nurses in triage decision making was average (k=0.56).Conclusion: Low knowledge of the nurses about hospital triage could be due to lack of formal training courses and lack of obligation of the emergency departments on evidence-based decision making. Establishing academic courses for triage nursing and developing national triage scale is recommended.

Introduction: Anxiety has many devastating effects on the individuals, so this study aimed to determine anxiety level and psychological and environmental factors on anxiety of the family of the patients hospitalized in Intensive Care Units.Methods: This was a cross-sectional study conducted in 2007.218 family members of 130 patients were selected in simple sampling method in meeting times of the Therapeutic Educational Centers. Collecting the data was done using two questionnaires: “standardized hospital anxiety and depression scale” and “researcher made”. The data were analyzed using chi-square test and logistic regression through software SPSS 15.Results: The odds ratio of anxiety outbreak in individuals who remarked that visiting behind the window affect their anxiety was 4.4 times more than that in the individuals who remarked visiting behind the window does not affect their anxiety (OR=4.404). In addition, the odds ratio in cases with lack of face to face visiting, poor economic condition, family concerns on hospital costs and family member role changing were 3.550, 3.904, 2.501 and 4.308, respectively.Conclusion: Observing pipes and fittings, visiting behind the window, lack of face to face visiting, poor economic condition, family concerns about hospital costs and family member role changing were the effecting factors in increasing odds ratio of the families’ anxiety. Considering these factors and familycentered cares can significantly reduce anxiety level of the families.

Introduction: Lack of application of the nursing process can reduce the quality of care so this study aimed to diagnose the nursing process barriers from the view of the Intensive Care Units’ nurses.Methods: This cross-sectional descriptive study has been done on 63 nurses of Intensive Care Units that were chosen from selected hospitals in Tehran, based on cluster-random sampling method in 2010. The data gathered using a researcher made questionnaire and analyzed using descriptive-analytical statistical method.Results: The most important individual barriers from the view of nurses were lack of sufficient information about concept of the nursing process (79.4%) and lack of belief in doing the patient care according to the nursing process (74.6%) and inadequate learning about the nursing process in intensive care units (71.4%). In addition, the most important management barriers were lack of enough time for doing the nursing process due to excessive number of the patients (84.1%), lack of authorities' support for implementation of the nursing process (76.2%) and submitting non-nursing duties to the nurses (76.2%).Conclusion: Health care authorities must help in promotion of the health care with employing sufficient nurses, educating them and providing necessary situations for nursing process.

Introduction: Cardiovascular diseases are the major cause of mortality in women and men all over the world. This study aimed to evaluate the prevalence of cardiovascular diseases and associated risk factors in the elderly people.Methods: This descriptive study has been done on 382 elderly people in 2009. Samples were chosen from different regions of Tehran city by random-cluster sampling method. Data was collected by researcher made questionnaire and also measurement of the height and weight (body-mass index), blood pressure, blood lipids and fasting blood sugar. The data analyzed using descriptive-analytical statistical method and SPSS 17 software.Results: Risk factors of cardiac vascular diseases (and their prevalence) included obesity and overweight (48.1%), high triglyceride (37.2%), lack of exercise (36.4%), high cholesterol (32.2%), high systolic (%31.4) and diastolic (28.0%) blood pressure, cardiovascular diseases (27.3%), tobacco consumption (19.7%), high fasting blood sugar (14.7%), and positive family history (13.4%). Prevalence of different risk factors of cardiac vascular diseases was significantly higher in men than women (P<0.05) except fasting blood sugar, physical inactivity and lack of exercise.Conclusion: The results of the present study showed that the prevalence of risk factors for cardiac vascular diseases was high and higher in men than women. Therefore, educating individuals, control of risk factors and screening are suggested.