پرستاری داخلی و جراحی
سال:1398 | دوره: | شماره: |تعداد مقالات:8

Background: Spiritual health is considered one of the most important components of health and palliative care that facilitates harmonious and integrated communication among one’ s inner forces. One of the basic principles of holistic nursing care is to pay attention to the spirituality and spiritual care of patients. Spiritual care is an important source of adaptation in refractory and chronic patients such as cancer. Objectives: The aim of this study was to determine the eff ect of spiritual care on the spiritual health of adolescents with cancer. Methods: This pre-experimental, single-group, pre-post study was performed on 35 adolescents with cancer admitted to Imam Ali Teaching Hospital in Zahedan from May to September 2019. Convenient sampling technique was performed to carry out the study based on inclusion criteria. Data collection tools included demographic information questionnaire and Paloutzian and Ellison Spiritual Health questionnaire. Before and after the spiritual care intervention, the required data were collected by interviewing adolescents and using questionnaires. The data were analyzed using Shapiro-Wilk test and paired t-test. Results: Adolescents’ overall spiritual health score increased from 52  7. 34 before the intervention to 102  6. 57 after the intervention and the diff erence was signifi cant (P = 0. 001). Conclusions: According to the fi ndings of the present study, spiritual care is eff ective in the spiritual health of adolescents with cancer and can promote adolescent spiritual health. Therefore, it is suggested that nurses incorporate spiritual care into their patient care plans as a simple, accessible, safe and aff ordable way to promote their spiritual health.

Background: Breast cancer and its treatment could both lead to numerous physical and psychological complications. Alleviating these problems requires increasing the quality of life of patients. Therefore, it is important to understand the quality of life of these individuals and identify its aff ecting variables so as to develop interventions for improving both their quality of life and self-care behaviors. Objectives: The purpose of this study was to explore the eff ect of self-care education on the quality of life of women with breast cancer undergoing chemotherapy at two hospitals affi liated with Zahedan University of Medical Sciences in 2019. Methods: This quasi-experimental two-group study was performed on 90 women with breast cancer who had been admitted at two teaching hospitals of Zahedan University of Medical Sciences. Convenience sampling was used to recruit the subjects who were then randomized into the experimental (n = 45) and control (n = 45) groups. The two groups fi lled out a demographic questionnaire in addition to the European Organization for Research and Treatment-QOL and Breast Cancer Specifi c Module questionnaire (EORTC QLQ-C30 and QLQ-BR23). The control group only received routine care. The questionnaires were completed again six weeks after the intervention. Data analysis was conducted in SPSS-21 using independent t-test, chi-square test, paired t-test, and Shapiro-Wilcoxon test. Values below 0. 05 were considered statistically signifi cant. Results: Totally, 90 participants completed the study. The mean and standard deviation of the general quality of life in the experimental group increased from 52. 59  21. 08 before the intervention to 78. 88  12. 38 at the end of the study (P = 0. 001). Besides, the mean general quality of life was 78. 88  12. 38 in the experimental group and 56. 11  17. 62 in the control group, indicating a statistically signifi cant diff erence between the two groups (P = 0. 001). Conclusions: According to the fi ndings of this study, self-care training can lead to an increase in the quality of life in patients with breast cancer. It is therefore suggested that this education be adopted as a major principle in care planning for these individuals.

Background: Intrahospital transfer of critical patients is due to diagnostic, therapeutic objectives or hospitalization in specialized units. This transfer could prompt cardiovascular, respiratory, and physical problems for patients with critical conditions. Objectives: The present study attempts to determine the impact of training nurses in regards to the use of safe transfer checklist on the quality of in-hospital transfer of critical patients. Methods: This quasi-experimental study was performed in two hospitals affi liated with Zahedan University of Medical Sciences between July and December 2018. Khatam Hospital and Ali ebne Abitaleb Hospital were selected as the control and intervention (checklist) groups, respectively. In the control hospital, 65 cases of intrahospital transfer were evaluated by observing the performance of the transfer team, and the researcher completed the checklist. Next, in the intervention hospital, the researcher organized a workshop on using the safe transfer checklist. After a month, 65 cases of intrahospital transfer in this hospital were monitored and the safe transfer checklist was completed. Data were analyzed in SPSS 22 using chi-square test and independent t-test. P < 0. 05 was considered statistically signifi cant. Results: The mean age of patients was 43. 68 years in the control group and 47. 95 years in the intervention group. The majority of patients (76. 9% in the control group and 61. 5% in the intervention group) were male. The mean score of intrahospital transfer quality was 11. 21  2. 84 in the control group and 16. 52  2. 08 in the intervention group. Independent t-test showed a signifi cant diff erence between the two groups in terms of transfer quality (P < 0. 001), with the intervention group scoring higher than the control group. Conclusions: Teaching nurses to apply the safe transfer checklist in moving critical patients inside the hospital can improve the quality of transfer, and, ultimately increase the safety of critical patients.

Background: From patients’ perspective, pain is the most frequent complaint after surgery, which results in many complications such as sleep disorder, atelectasis, myocardial ischemia, respiratory infection, immune system disorder, and anxiety. In this context, deploying complementary and low-risk methods is extremely important in alleviating pain after orthopedic surgery. Objectives: This study explored the impact of transcutaneous electrical nerve stimulation (TENS) on pain intensity in patients after orthopedic surgery. Methods: This clinical trial was performed on 80 individuals admitted to the orthopedic ward of Khatam al-Anbia Hospital, Zahedan, Iran, in 2017. The patients were enrolled at least 24 hours after surgery and randomized into intervention (n = 40) and control (n = 40) groups. Pain was initially measured in the two groups using a visual analog scale. Then, the intervention group received TENS for 30 minutes. Finally, pain scores were re-evaluated in the both groups. Results: The subjects did not have any signifi cant diff erence in terms of demographic variables. The mean pain intensity after the experiment was signifi cantly diff erent between the intervention (3. 17  1. 75) and control (4. 97  1. 86) groups, with the former perceiving less pain. Conclusions: TENS is eff ective in reducing pain after orthopedic surgery and is suggested to be administered in combination with medication to enhance pain relief.

Background: Psoriasis is an infl ammatory skin disease with detrimental eff ects on patients’ physical, mental, and social health. Living with this physical skin disorder can pose a threat to patients’ identity and bring about unwanted changes to their role, mental image, and lifestyle. Hence, the analysis of diff erent experiences and perceptions of people living with psoriasis can help healthcare managers and policymakers in adopting the most effi cient coping strategies. Objectives: The study aimed to explain the experiences of young girls with psoriasis. Methods: This qualitative descriptive phenomenological study was conducted using in-depth, semi-structured interviews with 10 young girls with psoriasis who referred to the Dermatology Clinics of Zahedan hospitals in 2018-2019. The participants were selected using purposive sampling and the data were analyzed by Colaizzi’ s method. Results: The themes describing the experiences of young girls with psoriasis included the challenging emergence of disease, indefatigability in pursuit of ineff ective treatment, social stigma as a community gift to the patients, and fear of uncertain future. Conclusions: The challenges of the incidence of disease at a young age and insistence on ineff ective treatments were highly evident in the experiences of patients. The patients were also concerned about the social stigma associated with the disease, which could pose further challenges to their uncertain future. According to the fi ndings, increasing public awareness of the disease and applying psychological strategies can be eff ective in addressing the problems of psoriasis patients. Elevating the awareness of families to accompany the patients in treatments can also be another eff ective measure.

Background: Depression and anxiety are common problems with multiple complications in hemodialysis patients. Objectives: This study aimed to compare the eff ect of acupressure and refl exology on anxiety and depression in hemodialysis patients. Methods: A clinical trial was carried out on 60 patients who had referred to the Special Patients Clinic, Zabol, between January and March 2017. Patients were randomly divided into three groups, acupressure group (n = 20), refl exology group (n = 20), and control group (n = 20). Data collection tools included the Spielberger State-Trait anxiety inventory (STAI) and the Beck depression inventoryII (BDI-II). Data were analyzed in SPSS-19 using descriptive and analytical statistics. Results: Before the intervention, there was no signifi cant diff erence between the three groups in terms of depression (P = 0. 051) and anxiety (P = 0. 11). The comparison of the mean scores of depression and anxiety between the three groups after the intervention revealed a signifi cant diff erence between the three groups in terms of both variables (P < 0. 001). Statistical analysis indicated that the depression and anxiety scores diff ered signifi cantly after the intervention between the two experimental groups and the control group (P < 0. 001). Conclusions: The results demonstrated that acupressure and refl exology could have positive impacts on mitigating the patients’ depression and anxiety. Thanks to the ease of application, these methods can be used by nurses to reduce anxiety and depression in patients undergoing hemodialysis.

Background: Inadequate oral care in ICU patients can lead to lethal complications such as ventilator-associated pneumonia (VAP). Objectives: The purpose of this study was to compare the eff ect of oral care using miswak and chlorhexidine mouthwash on the incidence of VAP in ICU patients. Methods: This single-blind randomized clinical trial was carried out in 2018 on 70 patients undergoing mechanical ventilation in the intensive care units of Khatam-al-Anbia Hospital in Zahedan, Iran. The inclusion criteria were the insertion of endotracheal tube, scoring 10 or below based on Beck oral assessment scale (BOAS), scoring below 5 based on the modifi ed clinical pulmonary infection score (MCPIS) at the beginning of the study, absence of chronic pulmonary disease, and no history of pulmonary aspiration. The subjects were selected through convenience sampling and randomly divided into the intervention (n: 35) and control (n: 35) groups. For fi ve days, oral care was administered using miswak in the intervention group and chlorhexidine mouthwash in the control group. Data were collected through a demographic and clinical information questionnaire, MCPIS, and BOAS. After normality tests, the obtained data were analyzed in SPSS 22 using independent t-test, chi-square test, and Fisher’ s exact test at the signifi cance level of P < 0. 05. Results: The two groups were similar in terms of age, gender, cause of hospitalization, level of consciousness, administered antibiotics, history of ICU admission, and smoking. After oral care with miswak, none of the patients in the intervention group developed VAP, but 6 patients in the control group (17. 1%) were diagnosed with this condition. The results of Fisher’ s exact test showed a significant diff erence between the two groups in terms of VAP incidence (P = 0. 01). Conclusions: In addition to promoting the oral health of ICU patients, miswak can mitigate the incidence of ventilator-associated pneumonia. Therefore, because of its availability, cost-eff ectiveness, and fewer side eff ects compared to chlorhexidine mouthwash, it is strongly recommended to be administered to ICU patients.

Background: Hemodialysis (HD) treatment in patients with chronic kidney disease (CKD) is a long-term process, which cannot be suffi ciently eff ective without the patient’ s own involvement and self-care activities. Objectives: The aim of this study was to disclose the eff ect of telenursing on self-care behaviors of patients undergoing hemodialysis at Ali Ibn Abitalib Hospital, affi liated with Zahedan University of Medical Sciences in 2019. Methods: In this clinical trial, 80 HD patients were chosen via convenience sampling and randomly assigned to the experimental and control groups. Data were collected using a demographic questionnaire and an 18-item scale assessing HD patients’ self-care behaviors. The experimental group received a 12-week training program, which was held twice a week (each lasting 15 minutes). Follow-up was performed through phone calls during this period. On the other hand, the control group received only routine hospital instructions. The self-care questionnaire was completed before and 12 weeks after the intervention. The obtained data were analyzed in SPSS-22 using chi-square test, independent t-test, paired t-test, and ANCOVA. P values less than 0. 05 were considered statistically signifi cant. Results: A total of 80 subjects completed the study. Except for age, the two groups were not signifi cantly diff erent in terms of demographic variables. The mean score of self-care before the intervention was 24. 40  14. 73 in the experimental group and 19. 45  14. 11 in the control group. After the intervention, this score changed to 48. 65  9. 19 in the experimental group and 20. 40  13. 46 in the control group, suggesting a signifi cant diff erence in self-care between the two groups. Conclusions: Telenursing promotes self-care in HD patients. Thanks to the availability of telephone and the low cost of training for this method, health authorities/policymakers and nurses can deploy telenursing to cultivate self-care behaviors in these patients.