Medical-Surgical Nursing Journal
Year:2020 | Volume:9 | Issue:4|Papers Count:7

Background: Patients' oral health is impaired in Intensive Care units (ICUs) due to loss of consciousness, open mouth, intubation, and mechanical ventilation. Objectives: The current study aimed to compare the effects of comprehensive and combined programs on oral health in patients under mechanical ventilation. Methods: This single-blind clinical trial with three groups was performed on 90 patients with mechanical ventilation admitted to ICUs of medical centers affiliated to the Zahedan University of Medical Sciences, Iran, in 2020. Patients under mechanical ventilation were randomly divided into three groups, including those receiving a comprehensive program, those receiving a combined program, and controls through permutated blocks. In the two intervention groups, oral care was performed for 5 minutes, three times per day, during the 5 days of the study with a specific method. The control group received routine oral care. The patients’ oral health was measured once before the intervention and then every day until the fifth day of the intervention using the Beck Oral Assessment scale. The data were analyzed using the analysis of variance and chi-square in IBM SPSS Statistics software version 26. Results: The mean oral health score in the three groups was not significantly different before the intervention and on the second day of the study (P > 0. 05). However, on the third to fifth days of the study, the oral health score in the two intervention groups showed a significant decrease compared to the control group, indicating an oral health improvement in these groups (P = 0. 001). The mean oral health score in the control group increased during the study days. Conclusions: Comprehensive care and combination methods can improve oral health in patients under mechanical ventilation. Nurses are recommended to use regular and codified oral care methods.

Objectives: The purpose of the present study was to determine the effect of chamomile extract on the prevention of peristomal skin complications. Methods: This single-blinded, placebo-controlled, randomized clinical trial was conducted on 80 ostomy patients who were referred to Koroush Health Clinic, Isfahan, Iran. For the participants in the intervention group, chamomile extract was applied topically on the peristomal skin. For the participants in the control group, distilled water was applied as a placebo. The intervention group participants’ peristomal skin was examined using the ostomy skin tool (OST) once a week for four consecutive weeks. The peristomal skin in the control group was assessed at the beginning and the end of the study. Results: The intervention and control groups were not significantly different in terms of gender, marital status, educational degree, ostomy type, chemotherapy history, and radiotherapy history. The scores of the OST indicated that after the intervention, the scores of skin complications (color change, secretion, and wound) around the stoma were significantly higher in the control group than in the intervention group (P < 0. 05). Conclusions: Our findings showed that chamomile extract was effective in preventing peristomal skin complications and related side effects. The results of the present study can be used by health care professionals to manage peristomal skin complications.

Background: Pain is defined as an unpleasant sensory experience associated with actual or potential damage to body tissues. Therapeutic procedures cause fear in children, which in turn leads to physical and mental stress. Objectives: This study aimed to investigate and compare the effects of aromatherapy and distraction on the pain caused by venipuncture among hospitalized children. Methods: In this clinical trial study, 90 children hospitalized in the pediatric ward of Ali-Ebne-Abitaleb Hospital in Zahedan in 2018 are examined. The eligible children were selected using the convenience sampling technique and were divided into three groups (n = 30) using stratified permuted block randomization. In the distraction group, a Kolah Ghermezi (Red Hat) puppet was used to play with the children before and during venipuncture. In the aromatherapy group, lavender essence was used 20 minutes before the beginning of venipuncture. No intervention was provided in the control group. The children’ s pain intensity was measured using OUCHER standard instrument 10 minutes after the end of venipuncture. Data were analyzed by SPSS version 24 using descriptive statistics, one-way ANOVA, Kruskal-Wallis, and post-hoc tests analyses. Results: A significant difference was found between the two intervention groups and the control group. Accordingly, both interventions could significantly decrease the pain intensity (P < 0. 001). However, there was no significant difference between the two intervention groups concerning the impacts of interventions on the pain intensity. Conclusions: A significant difference was found between the two intervention groups and the control group. Accordingly, both interventions could significantly decrease the pain intensity (P < 0. 001). However, there was no significant difference between the two intervention groups concerning the impacts of interventions on the pain intensity.

Background: It is important to address the problems of parents of children with cancer to reduce the negative consequences, especially in mothers as primary caregivers. Objectives: The present study aimed to determine the effect of cognitive-emotional intervention on the psychological distress of mothers of children with cancer in the chemotherapy ward. Methods: This randomized clinical trial was conducted on 100 mothers of children with cancer who presented to the chemotherapy ward of the hospitals affiliated to Zahedan University of Medical Sciences in 2018. The eligible mothers were chosen conveniently and then randomly assigned to intervention and control groups. Mothers in the intervention group received five sessions of cognitive-emotional intervention, two sessions per week. Each session took about 60 to 90 minutes on average per group. Before and sixteen weeks after the end of the intervention, data were collected using the Kessler Psychological Distress scale (K-10). The data were analyzed using SPSS 21 utilizing statistical tests, including independent and paired t-tests, Chi-square, and covariance analysis. Results: Although there was no difference in the mean score of psychological distress before the intervention (P = 0. 5), but the results showed that the mean score of psychological distress of mothers of children with cancer after cognitive-emotional intervention was significantly lower in the intervention group (6. 16 ± 3. 40) than the control group (16. 84 ± 6. 67) (P = 0. 001). Conclusions: Cognitive-emotional intervention had a significant positive effect on reducing psychological distress in mothers of children with cancer. Such interventions are recommended for parents, especially mothers in the chemotherapy ward.

Background: Patients with renal insufficiency who receive hemodialysis should be continuously monitored to avoid possible complications, as they are at increased risk of several problems, including pruritus, as one of the most annoying problems. It seems that dialysis adequacy affects the pruritus of hemodialysis patients. Objective: The current study aimed to investigate the effect of dialysis solution temperature and stepwise ultrafiltration profile on dialysis adequacy and pruritus of hemodialysis patients. Methods: Following a single group quasi-experimental design, 34 eligible hemodialysis patients admitted to the hemodialysis ward of Zahedan Medical Center (Iran) in 2020 were recruited using the convenience sampling technique. All patients attended three standard dialysis sessions (at a temperature of 37° C) and three cold dialysis sessions (36° C) with a stepwise dialysis ultrafiltration profile. Dialysis adequacy was measured at the end of each session, and Yosipovitch’ s Pruritus Severity Scale (PSS) was filled before and after each dialysis session. Data were summarized using descriptive statistics (i. e., frequency, mean, and standard deviation). Mean scores before and after dialysis were paired by t-test using SPSS version 22. Statistical significance was considered when P-value < 0. 05. Results: The mean and standard deviation of dialysis adequacy in both standard dialysis and cold dialysis techniques with stepwise ultrafiltration profile were 1. 18 ± 0. 36 and 1. 44 ± 0. 48, respectively, indicating that dialysis adequacy of the cold dialysis method with stepwise ultrafiltration profile was significantly higher (P = 0. 001). Besides, the mean pruritus scores in the standard dialysis and cold dialysis methods with stepwise ultrafiltration profile were-0. 73 ± 0. 80 and-1. 73 ± 1. 16, respectively, showing a significant difference (P = 0. 001). Conclusions: Cold hemodialysis with a stepwise ultrafiltration profile can be used as a simple and low-cost technique to improve both dialysis adequacy and relieve pruritus in hemodialysis patients.

Background: The prevalence of cancer and its psychological consequences has increased steadily in recent decades. Hence, parallel to providing medical interventions, psychological therapies should be provided to cancer patients. Objectives: The present study aimed to determine the effect of hope therapy-based training on the happiness of women with breast cancer. Methods: In this quasi-experimental study, 100 female patients with breast cancer admitted to the chemotherapy wards of two hospitals affiliated to the Zahedan University of Medical Sciences (Iran) in 2020 are studied. Participants were selected using the convenience sampling technique and randomly divided into two groups of intervention and control (each with 50 subjects). The intervention group received eight sessions of group-based hope therapy training. Data were collected using a demographic information form and the Oxford Happiness questionnaire. Data were analyzed using SPSS version 16 by chi-square, independent samples t-test, and paired samples t-test, at a significant level of P < 0. 05. Results: There was no significant difference between the two groups concerning demographic characteristics. The independent samples t-test showed no significant difference in the mean scores of happiness between the two groups before the intervention (P = 0. 55). However, the mean score of happiness for the participants in the intervention group showed a significant increase after providing the intervention compared to the control group (P = 0. 001). Besides, the paired samples t-test indicated a significant increase in the mean score of happiness after providing the intervention compared to before intervention (P = 0. 001), while the mean score of happiness for the participants in the control group showed a statistically significant decrease (P = 0. 004). Conclusions: This study demonstrated that hope therapy-based training is effective for the happiness of women with breast cancer. Since physical and psychological problems caused by cancer lead to sadness and reduced happiness, hope therapy can be added to the care programs for women with cancer undergoing chemotherapy.

Background: The World Health Organization (WHO) has considered the ideal rate for cesarean sections to be 10-15%. The Iran Ministry of Health introduced the promoting natural childbirth program (PNCP) in 2014 to lower cesarean sections. Objectives: This study presents a model for the implementation of the PNCP. Methods: A mixed study was conducted to determine and prioritize the factors affecting the implementation of PNCP and present a model. We conducted a qualitative study to determine the effective factors of the program by examining the views of 15 gynecologists, anesthesiologists, midwives, and managers in 2019 at Zabol Medical Sciences University. Semi-structured individual and group interviews were used and analyzed with MAXQDA16. In the quantitative phase, a questionnaire of themes was prepared and ranked by 10 experts based on the Likert scale. Then, we used the technique for order performance by similarity to ideal solution with BT TOPSIS solver software to confirm and rank the themes and design a model. Results: The model included six main themes extracted from the qualitative phase. In the quantitative phase, they were approved and prioritized by experts in the following order: 1) Creating a Culture for Natural childbirth, 2) Strong and committed leadership, 3) Empowerment, 4) Education, 5) Comprehensive support, and 6) Optimization. Conclusions: The model can provide useful insight for policymakers and care providers to make more qualified decisions, determine the status quo, allocate resources, and enforce policies.