Evidence-based Care Journal
Year:2013 | Volume:2 | Issue:4 (5)|Papers Count:8

Background: Regular physical activity is one of the most important factors in creating, maintaining and promoting health, which is not enough in women with diabetes due to the high prevalence of obesity.Aim: This study aimed to determine the effect of educational intervention on self-regulation strategies in promoting physical activity in women with type 2 diabetes.Methods: This study was a randomized controlled trial in which 82 women with type 2 diabetes were allocated randomly to intervention and control groups. Data collection tools consisted of questionnaires to assess knowledge, goal setting, planning and physical activity. Educational intervention to promote physical activity was performed in 7 sessions of 60-minute through goal setting and planning for physical activity and behavioral self evaluation. Program evaluation was performed before and immediately after intervention and at followup period. The data were analyzed with SPSS software Version 11.5 using repeated measures ANOVA and T testes (P<0.05).Results: The mean age of participants was 49.07±6.26. The intervention group was significantly different in relation to goals (P<0.001), planning (P<0.008), knowledge (P<0.001), physical activity (P<0.004) in evaluation period. Also experimental group showed a significant decrease in FBS (From 164.78±46.38 to 150.73±37.55, P<0.019) and BMI (From 70.43±9.93 to 68.39±6.62, P<0.001) at the follow up period, the data were analyzed using the SPSS software version 11.5, the repeated mager ANOVA, T testes (P<0.05).Results: The mean age of participants was 49.07±6.26. The intervention group was significantly different in relation to goals (P<0.001), planning (P<0.008), knowledge (P<0.001), physical activity (P<0.004) in evaluation period. Also experimental group showed a significant decrease in FBS (From 164.78±46.38 to 150.73±37.55, P<0.019) and BMI (From 70.43±9.93 to 68.39±6.62, P<0.001) at the flow up period compared with the time before intervention.Conclusion: Educational intervention through self-regulation strategies lead to increase physical activity, improved FBS and BMI in women with type 2 diabetes.

Background: Today, coronary artery bypass graft surgery (CABG) in many patients is commonly used to treat complications of the disease.Aim: This study aimed to evaluate the impact of cardiac rehabilitation on hemodynamic parameters in patients undergoing CABG.Methods: In this clinical trial which was conducted in Rajaee Hospital of Tehran University of Medical Sciences 100 patients after coronary artery bypass graft surgery procedure were randomly allocated into two experimental and control groups. Phase 2 of cardiac rehabilitation program was conducted for 24 sessions for the experimental group and the control group received the routin program. To collect the demographic data and hemodynamic parameters, demographic questionnaire and hemodynamic check list were used. Data were analysis with SPSS software Version 17 using Chi-square and independent T-test and also repeated measurements ANOVA.Results: The experimental and control groups were not significantly different in terms of demographic variables. There was a significant difference in the mean score of heart rate 8 weeks after rehabilitation program between experimental and control group, i.e. the heart rate was 5 beats per minute lower in the experimental group (P=0.006). No significant difference was seen in other hemodynamic parameters in two groups. Conclusion: The results indicate that cardiac rehabilitation program could relatively improveme some of the hemodynamic parameters. Therefore, more attention to the implementation of cardiac rehabilitation programms is necessary.

Background: Asthma is the most common chronic disease of childhood, which is increasing in prevalence worldwide. Parents try to find the ways to overcome their anxiety of chronic diseases such as asthma. This study was designed to determine the effect of massage therapy for children on anxiety level of mothers with asthmatic children.Aim: This study aimed to determine the effect of combined massage therapy for children with asthma on maternal anxiety is a clinical trial that was performed in asthma and allergy clinic of Tabriz University of Medical Sciences in 2012.Methods: This study was a clinical trial that was carried out in asthma and allergy clinic of Tabriz University of Medical Sciences in 2012. Sixty children with asthma aged 6-14 years were randomly allocated into two groups. Mothers in the massage group were instructed massage techniques, and they were asked to do massage therapy for their children 30 minutes every night at bedtime for one month in addition to standard treatment. The control group performed only standard asthma treatment. At the beginning and end of the study, the data were collected by Spielberger State-Trait Anxiety Inventory. The data were analyzed by the SPSS software version 18 using independent t test, paired t test, Chi-square and ANCOVA. Results: The mean age of the mothers was 34.78±4.18 years. The scores of State and Trait anxiety in both groups before the intervention, was not statistically different. But there was statistically significant difference in terms of State (41.23±11.65 vs. 35.83±6.88), and Trait) 45±12.31 vs. 39.96±8.07) anxiety mean score in the experimental group before and after intervention (P<0.05).Conclusion: Maternal anxiety level decreases following combined massage therapy. It seems that the active role of the mothers in the care of their children can improve emotional health and decrease anxiety level.

Background: To achieve quality care is an important issue that is often paied attention to in providing nursing care. It seems that communication skills can affect the quality of care. Aim: This study investigated the effect of communication skills training on the quality of nursing care in patients.Methods: The study was a pretest/posttest experimental design with control group. 60 nurses working in Qhaem and Emamreza hospitals were selected using stratified sampling and then randomly allocated to two groups, Also three patients per each nurse were selected using convenience sampling before and also one, two and three weeks after the intervention. The intervention included communication skills training workshop which was held for eight hours over two days in 2012. Data collection tools included demographic data sheet, Quality Patient Care Scale (QUALPAC) and communication skills Check list. The data were analyzed by SPSS software version 16 using t student test, Mann-Whitney, Wilcoxon and ANOVA tests. Results: The mean score for overall quality of care in communication skills training group was significantly higher at the 2nd, 3rd, and 4th weeks after the intervention compared with control group (p<0.001). This increase was not similar in different dimensions of quality of care. It was 50.8% in the individual psychosocial, 63.8% in the group psychosocial, 54.4% in the relationship, 50.6% the physical, 41% in the general and 98% in the professional dimension. In both intervention and control group, the mean score for overall quality of care significantly decreased at the 2nd, 3rd, and 4th weeks after the intervention compared with preintervention period (p<0.001).Conclusion: As communication skills training is an effective method to improve the quality of care, it is suggested that managers and staff to consider it to improve the quality of patients' care.

Background: Anxiety and depression are both predisposing and consequent factor in patients with myocardial infarction (MI). Thus relief of anxiety and depression has an important role in reducing possibility of further MI and also quality of life promotion. Aim: The aim of the current study was to determine the effect of cognitive behavioral therapy (CBT) on the anxiety and depression in patients with MI. Methods: In this experimental study 30 patients, hospitalized in the CCU ward were randomly allocated into control (15) and experimental group (15). Subjects in experimental group underwent ten sessions of CBT interventions individually while the control group did not received any intervention. SCL-90 questionnaire which measures both depression andanxiety was completed for both groups in Pre-and post-intervention phases. Data analyzed using statistical tests of Chi-square, Mann-Whitney, and independent T-Test and paired T-Test. Results: The mean age of participants was 55.69±6.73 years of which 60% were women. The mean scores of depression and anxiety were not significantly different between two groups before treatment (p>0.05). But t-test showed that mean depression score after intervention in the control group (1.2±0.38) was significantly higher than the treatment group (0.7±0.33). Similarly, the mean anxiety score in the control group (1.09±0.27) was significantly higher than the experimental group (0.63±0.27). The subjects who received CBT had fewer depression and anxiety symptoms.Conclusion: Individual CBT intervention was effective in decreasing the anxiety and depression of MI patients.

Background: Appropriate sensory excitation can improve brain synaptic contact and establish consciousness.Aim: The aim of this study was to investigate the sensory excitation delivered by family members and nurses on the level of consciousness in patients who are admitted to ICU. Method: In this clinical trial, 69 patients admitted to ICU in Ashair and Shafa Hospital, Khorammabad, were randomly assigned into two interventions and one control group. The first intervention group received sensory excitation by family members, and the second intervention group by the nurses. Control group were not received any intervention. Intervention was applied two hours a day at 4-5 pm and 8-9 pm to the intervention groups for six days. For all subjects in these three groups, the level of consciousness was measured twice at 5 minutes before and 30 minutes after intervention by the research assistant using Glasgow Coma Scale (GCS). The data were analyzed by SPSS software version 18 using repeated measures and ANOVA tests.Results: A significant discrepancy was observed between experimental groups in average increasing in GCS before and after intervention based on covariance analysis test results (P<0.001). In addition, the first intervention groups showed the higher increase in GCS score (0.388±0.032 units) and the second intervention the moderate increase (0.268±0.032 units). The lowest increase was found in control group (0.44±0.032 units). Conclusion: Sensory excitation performed by family members is more effective to improve the level of consciousness of coma patients than the nurses, thus it is suggested to provide conditions in which the nearest family members can do the sensitive excitation program for patients hospitalized in ICU ward subject to receiving adequate training.

Background: Brucellosis is one of the important zoonotic diseases with variety of symptoms and signs. Using of cost effective, easy and safe diagnostic methods in screening of brucellosis is an important priority. Several studies have been carried out to recognize appropriate diagnostic methods and each have reported different results.Aim: The aim of this study was to investigate the sensitivity of Wright, Coombs Wright and 2-Mercapto Ethanol tests in diagnosis of brucellosis. Method: In these cross-sectional study 340 diagnosed inpatient cases of brucellosis from Hasheminejad Hospital, Mashhad was included in 2008. Demographic characteristics, clinical signs and laboratory results of subjects were collected. Data analysis was done by SPSS11.5 and diagnostic sensitivity of Wright, Coombs Wright and 2-Mercapto Ethanol were assessed. Results: Results showed that %54 of participants was male and %58 was in 20-40years old age group. The most common symptoms were fever (%34) and arthralgy (%22). Among patients there were 324 positive Coombs Wright test and 318 positive 2ME test. The sensitivity of Wright test was 92% (CI%95=83-95) and 80.6% (CI%95=76.6-85.1) according to the basis 1:80 and 1:160. Sensitivity of Coombs Wright and 2ME tests were 95.3% (CI%95=91.3-97.7) and 93.7% (CI%95=91.1-95.6), respectively.Conclusion: To diagnose brucellosis Wright, Coombs Wright and 2ME tests, which are commonly used in Iran, are effective tests compared with other new and expensive diagnostic tests.

Background: The hemodialysis patients, who are able to make better use of adaptive techniques, accept the treatment easier and will have a higher quality of life.Aim: The aim of this study was to measure the effect of training of coping methods (problem-focused and emotion-focused) on quality of life in hemodialysis patients.Methods: This was a one-group before- after quasi-experimental design, in which 38 hemodialysis patients admitted at the Ali ebn Abi Talib Hospital in Rafsanjan 2010, were included. Quality of life questionnaire (SF36) and Lazarus Jalowiece Coping Style Questionnaire were used to measure the patients' quality of life and coping styles before intervention. Coping strategies were then trained and quality of life and coping styles were measured again after intervention. Data analysis was performed with SPSS Software Version 18 using paired t-test, ANOVA and Fisher's exact test.Results: Most of the subjects were female, married, with a mean (SD) age of 51.42±20.50 years. The mean score of quality of life was 89.03±19.35 before versus 98.89±16 after intervention. The mean score of quality of life was increased 9.85 after training compared to the baseline. Paired t-test showed significant difference between the scores of quality of life before and after intervention (p<0.0001).Conclusion: The results indicated that coping methods training can promote the use of problem-based instead of emotion-focused coping strategies, which intern could enhance patients' quality of life.