Medical-Surgical Nursing Journal
Year:2019 | Volume:8 | Issue:3|Papers Count:8

Background: Delivery is a major event that the vast majority of women experience during their lives with inevitable pain. Uncontrolled pain can prolong the labor process and cause multiple injuries to the mother and fetus. Thus, introducing measures to relieve labor pain, especially by noninvasive procedures, should be a priority in obstetrics and gynaecology. Objectives: This study aimed to compare the eff ect of hot and cold massage at spleen 6 (SP-6) on pain relief during active labor. Methods: This clinical trial was conducted in 2017 on 80 primiparous women who had referred to Amir Al-Momenin Hospital in Zabol, Iran. The subjects were randomly assigned to two groups of hot and cold massage. The eff ects of hot and cold massage (four sessions of 30 minutes) at SP-6 on pain relief were studied during the active labor before the intervention, 5 and 30 minutes after the start of the intervention, and 30 minutes after the end of the intervention. The results were compared between the two groups. A demographic form was used to collect demographic and midwifery characteristics and McGill Pain Questionnaire was adopted to evaluate pain intensity. Data were analyzed in SPSS V. 21 using descriptive and analytical statistics. Results: There was no statistically signifi cant diff erence in the mean pain intensity between the two groups before the intervention (P = 0. 606). Similarly, no signifi cant diff erence was observed in terms of pain intensity between the two groups 4 minutes after the intervention (P = 0. 248). However, 30 and 60 minutes after the end of the intervention, the reduction in pain intensity was signifi cantly more in the cold massage group than in the hot massage group (P < 0. 001). Conclusions: The results showed that cold massage at SP-6 signifi cantly relieved labor pain more eff ectively than hot massage. Thanks to its low cost and non-specialized equipment, it is recommended that treatment teams utilize this method to help mothers experience less pain during their labor process.

Background: Patients with angina pectoris need the training to control their disease. This training is mainly provided by nurses; therefore, they must be equipped with up-to-date and suffi cient knowledge and skills to be capable of caring for patients. Objectives: This study aimed at exploring the eff ect of lecture-based training and clinical training on the knowledge and skill of emergency nurses in caring for patients with angina. Methods: This randomized clinical trial was carried out between 2018 and 2019 on all nurses working at the emergency ward of three hospitals in Mashhad, Iran. Based on their working hospital, the subjects were randomized into three groups of lecture-based education, clinical training, and control. Using researcher-made questionnaires, nurses’ knowledge and skill in caring for patients with angina were assessed and compared before, immediately, and one month after the intervention. Data were analyzed by SPSS V. 22 using Kruskal-Wallis, one-way ANOVA, chi-square, and Friedman tests. Results: Friedman’ s test showed a signifi cant diff erence in nurses’ knowledge and skill scores of the two experimental groups at three stages of the study (P = 0. 001), such that these scores were lower before the intervention than immediately and one month after the intervention. Moreover, Kruskal-Wallis test revealed a signifi cant diff erence between the three groups in terms of knowledge and skill immediately after the intervention (P = 0. 001) and one month after the intervention (P = 0. 001), with the clinical training group scoring highest among the study groups in both of these stages. Conclusions: The results established that while both lecture-based education and clinical training could enrich nurses’ knowledge and skill in caring for patients with angina, clinical training depicts a greater effi cacy and durability. Hence, it is suggested that health policy-makers adopt clinical approaches in their attempt to enhance nurses’ skills and performance. Furthermore, studies with higher sample sizes are needed to evaluate the eff ectiveness and sustainability of these two educational methods in nursing.

Background: Nowadays, accidents among the elderly are of great importance due to the increasing population of the elderly and the eff ects of their lifestyles. Objectives: Therefore, the present study aimed to investigate the epidemiology of accidents among the elderly in Khorramabad, Iran, during 2016-2017. Methods: This descriptive-analytical study was conducted on 434 elderly individuals aged 60 years old and older who had experienced accidents and had referred to hospitals in Khorramabad. The census sampling method was used. The data collection instrument was a checklist to investigate the types of accidents among the elderly. Data were entered into SPSS software version 22 and analyzed using the chi-squared test at the signifi cance level of 0. 05. Results: The most common types of accidents were falls (64. 5%), burns (14. 7%), poisoning (14. 5%), trauma (6%) and drowning (0. 2%). There was a signifi cant diff erence between the two sexes in terms of type of accident (P = 0. 002). The prevalence of the abovementioned incidents was higher in females than males, except for poisoning, which was more common in males. There were no signifi cant relationships among the type of accident with age and the location of the accident. Conclusions: Fall as the most common accident in the elderly calls for the design of preventive programs to enhance both the lifestyle and the safety of the living environment. The higher prevalence of poisoning in men can be attributed to opioid abuse, which is more common among males.

Background: There are several factors such as noise and light, which aff ect the sleep quality of patients admitted to the cardiac care unit (CCU) and cause sleep disorders in these individuals. Objectives: The purpose of this study was to compare the impact of applying eye masks and earplugs as well as implementing the quiet time (QT) protocol on the sleep quality of patients hospitalized in the CCU of Ali Ibn Abi Talib Hospital in Zahedan. Methods: This clinical trial was performed on 135 CCU patients. Subjects meeting the inclusion criteria were chosen through convenience sampling. The patients were divided into three groups (control, eye mask and earplugs, and QT protocol) and were matched in terms of background variables. The subjects were studied over three days after admission. On the fi rst night, the patients’ sleep quality was determined by the Verran and Snyder-Halpern Sleep Scale (VSH), and on the second and third nights, the interventions (eye mask and earplugs and QT protocol) were administered. The next day, as the post-test, patients’ sleep quality was measured again. ANOVA test was used to determine and compare the mean sleep quality of the three groups, and the chi-square test was employed to compare the qualitative variables in the three groups. Results: After the intervention, the mean score of sleep disturbance was signifi cantly diff erent between the control and the two experimental groups. Also, the mean score of sleep effi cacy was higher in the eye mask and earplugs group than the other two groups, indicating a better sleep quality in this group. Conclusions: As low-cost devices with no side eff ects, eye masks and earplugs can improve the quality of sleep in [CCU] patients, and nurses could utilize them to help reduce environmental factors, which disturb patients’ sleep.

Background: Pulmonary changes and their respiratory consequences in patients with chronic obstructive pulmonary disease (COPD) could lead to many physical complications and are one of the major causes of hospitalization. Objectives: In this regard, the present study explores the effi cacy of self-care training on spirometric indices of COPD patients. Methods: This clinical trial was performed on 70 patients with COPD who had been admitted in 2017 to Ali Ibn Abi Talib Hospital in Zahedan, Southeast Iran. The subjects were recruited through convenience sampling based on the inclusion criteria and were subsequently randomized to the intervention and control groups. The self-care program was administered to the intervention group during eight 30-minute sessions organized within 4 weeks. Data collection tools included a demographic questionnaire and Vitalograph Alpha Spirometer. Data were analyzed in SPSS V. 21 using chi-square, Independent t-test, and Paired t-test at the signifi cance level of 0. 05. Results: The results of 8 sessions of self-care training revealed that the mean FVC index of patients before self-care education was 43. 40  8. 54 in the intervention group and 46. 54  10. 73 in the control group. After the educational program, the mean score of this index changed signifi cantly in the intervention group (48. 62  9. 30) (P = 0. 01), but no such alteration occurred in the control group (47. 11  10. 27) (P = 0. 16). Furthermore, the mean FEV1 index of the two groups diff ered signifi cantly after the self-care program (P = 0. 01). Conclusions: Given the impact of self-care training on improving spirometric indices in patients with COPD, it is recommended that nurses help ameliorate breathing status of these patients and relieve their symptoms by providing them with self-care instructions.

Context: Nursing grand rounds (NGR) is a method to improve the nursing image and shed light on the process of developing professionalism in nursing. It aims at promoting evidence-based practice and off ering an eff ective strategy to positively change patient care. In Iran, ground rounds is a relatively new concept; thus, there is little information about this strategy and its advantages and implementation. This study aimed to conduct an integrative review and classify the existing studies on NGR. Evidence Acquisition: The authors searched the keywords of ground rounds, nursing, and evidence-based practice in various databases including SID, Irandoc, Google Scholar, PubMed, Medline, Scopus, Cochrane Library, and ScienceDirect. Studies carried out between 2000 and 2019 fell within the scope of this study. The modifi ed version of Cooper’ s fi ve-step approach to literature review was used to examine and integrate the existing NGR knowledge. These steps included problem identifi cation, literature search, data evaluation (assessing the quality of data), data analysis and interpretation (summarizing the data), and result presentation. Results: The guidelines of Armola et al. (2010) were used in this study. Twelve studies meeting the inclusion criteria were reviewed and the results were presented in two areas of NGR benefi ts and implementation. Among the most important advantages of deploying NGR, one can point out that it provides an innovative and dynamic way to develop continuous and evidence-based learning to improve patient outcomes. Conclusions: NGR supports evidence-based nursing and more importantly, creates a social setting for learning not only science but also the art of nursing. Therefore, health care organizations should consider NGR as a way to demonstrate their commitment to developing nursing and evidence-based education and practice.

Background: Thalassemia negatively aff ects key aspects of life and self-care behaviors. It is essential to promote self-care behaviors in patients with thalassemia in order to improve their functions and mitigate adverse eff ects. Objectives: In this context, the present study aimed to investigate the eff ects of self-care education on self-care behaviors of patients with major -thalassemia based on Orem’ s model. Methods: This clinical trial investigated 60 patients with major -thalassemia who had been admitted to Razi Hospital in Saravan, southeast of Iran, in 2017. The subjects were selected and randomly allocated to the control and experimental groups. A demographic questionnaire and a researcher-made self-care scale were used to gather data. The experimental group received individualand group-training for 5 sessions of 30 to 45 minutes, while the control group was presented with routine instructions. After one month, the questionnaires were completed again and the data were analyzed in SPSS 23 using chi-square test and independent t-test. Results: The results of this study showed that administering the self-care program enhanced three aspects of self-care, including mental health, physical activities, and therapeutic measures in patients with major -thalassemia, but no improvement was observed in terms of nutrition after the intervention (P = 0. 28). Conclusions: It is promising to undertake self-care interventions to improve self-care behaviors of patients with major  thalassemia.

Background: Anxiety is one of the common complications resulting from invasive diagnostic methods, especially coronary angiography. It aff ects physiological responses of the patient and jeopardizes his/her vital signs in the angiography suite. Aromatherapy has suggested to reduce anxiety. Objectives: In this regard, the present study aimed at comparing the eff ects of orange and lavandula (lavender) essential oils on anxiety and physiological parameters of patients undergoing coronary angiography. Methods: This clinical trial was performed on 101 patients undergoing coronary angiography who were admitted to the Fatemeh Al-Zahra Hospital in Sari, northern Iran in 2018. Convenience sampling was done and the subjects were randomly divided into three groups, including the control, lavender and orange groups. Data collection was done using a demographic and disease questionnaire, Spielberger’ s state-trait anxiety inventory (STAI), a sheet to record physiological variations, a barometer and a second timer. The obtained data were analyzed by SPSS 22 using chi-square test, Fisher’ s exact test, one-way ANOVA, paired t-test, Tukey’ s post-hoc test, Kruskal-Wallis test, paired Wilcoxon test and Mann-Whitney U test. Results: The results indicated a signifi cant diff erence in the mean anxiety score between the lavender and control groups as well as the orange and control groups (P < 0. 001); a signifi cant diff erence was also observed between the orange and lavender groups after the intervention (P < 0. 001). Furthermore, systolic blood pressure, pulse rate and respiration rate decreased signifi cantly in subjects exposed to the lavender and orange essential oils compared to the control group (P < 0. 001). Conclusions: According to the fi ndings, orange and lavender aromatherapy could relieve anxiety in patients undergoing angiography. Accordingly, this intervention can be adopted as an eff ective measure in anxiety-ridden situations, like diagnostic procedures.