Journal of Caring Sciences
Year:2021 | Volume:10 | Issue:4|Papers Count:9

Introduction: A significant proportion of patients undergoing major gastrointestinal operations suffer from malnutrition. Although the benefit of postoperative nutritional support is well established, the effects of energy intake during pre-operative period is less reported. The present study was designed to test the effect of structured pre-operative nutritional therapy on the postoperative recovery of patients undergoing major gastrointestinal operations. Methods: A randomized clinical trial was conducted among 80 patients of the surgical gastroenterology department of a tertiary care center in south India. A simple random sampling method was used. The nutritional status of all participants was assessed by subjective global assessment (SGA). While control group received standard energy intake nutrition, the experimental group received calculated nutrition with an extra 50 g of soy protein for seven days pre operatively. Data were analysed using SPSS version 20. Results: The median day of removal of abdominal drainage tube was 3 (0-5) compared to 5 (2. 5-7. 5) in the control group. In the intervention group, the median time for the appearance of bowel sounds and starting of enteral feeding was 1. 1 (0. 5) days and 2 (1-2) days, while in the control group, it was 1. 6 (0. 9) days, 3 (1-4) days, respectively which was significant at P < 0. 05. Similarly, the mean (SD) postoperative serum albumin on third day was 3. 6 (0. 4) g/dL vs 3. 4 (0. 4) g/dL experimental and in the control group. Conclusion: Preoperative nutrition protocol improved the patients’ clinical outcomes in terms of post-operative serum albumin, the timing of bowel sounds, and early initiation of enteral feeds.

Introduction: Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus associated with increased morbidity and mortality and diminished quality of life (QoL). This study aimed to explore the effect of gender differences on QoL and adherence to self-care activities. Methods: In this cross-sectional study, we enrolled 135 male and 135 female patients with DFU. Data was collected using the Short Form Health Survey (SF-36) and a questionnaire that measured self-care activities (Diet, Exercise, Blood Examination, and Foot Check). Data analysis was performed using SPSS version 20. Results: In terms of QoL, male participants had moderate to high levels in the categories of energy/fatigue, emotional well-being, social functioning, and bodily pain, whereas they had low levels in physical functioning, physical role, and emotional role. Female patients had moderate QoL in the categories of energy/fatigue and social functioning, whereas they had low QoL in physical functioning, physical role, emotional role, emotional well-being, and bodily pain. Finally, regarding general health, male participants had moderate QoL and females had moderate to low QoL. Both males and females had low adherence to exercise and high in blood-examinations. For both genders, adherence to exercise had a statistically significant association with all sub-categories of QoL apart from those of role (physical and emotional). Conclusion: It is essential for health care professionals to provide gender-specific approaches in treatment of ulceration.

Introduction: Children are vulnerable to damage. Health problems in children, especially if necessitate hospitalization, can cause stress in their parents that may persist even long after discharge. This study aimed to investigate the effect of implementing follow-up care plans on stress in mothers of children discharged from pediatric surgical units. Methods: A quasi-experimental study was conducted on 64 mothers whose children were hospitalized in the surgical wards of two educational hospitals affiliated to Isfahan University of Medical Sciences, Iran. The participants were randomly assigned into two groups of control and experimental. The data collection tools included a demographic data questionnaire and stress response inventory (SRI). The interventions were performed using a four-stage follow-up care plan. The data were analyzed using SPSS software version 13 and descriptive statistics, independent t-test, repeated measures analysis of variance (ANOVA), and least significant difference (LSD) test. Results: The mean (SD) stress scores of the experimental group were 64. 1 (28. 8), 20. 4 (12. 4), and 11. 6 (7. 5) before, one week, and one month after the intervention, respectively. In the control group, these scores were 61. 2 (29. 2), 59. 9 (25. 5), and 46. 7 (19. 1), respectively. The results showed the mean score was significantly lower than that of the control group at one week and one month after the intervention in the experimental group. Conclusion: Our results demonstrated that a follow-up care plan can decrease the stress levels of mothers as a continuity of patient care even after discharge.

Introduction: Heart failure is the most prevalent cardiovascular disease. It is the end stage of most cardiovascular diseases and is characterized by the reduced ability of the heart to pump enough blood to fulfill the metabolic needs of the body. Self-care is the basis of the management of chronic diseases such as heart failure. The aim of this study was to explore the barriers to self-care among patients with heart failure. Methods: This was a qualitative content analysis. Participants were fourteen patients with heart failure and three healthcare providers who were purposively recruited from cardiac care centers in Zanjan, Iran. Data were collected through in-depth semi-structured interviews and were analyzed through the conventional qualitative content analysis approach proposed by Elo and Kyngä s. Results: Self-care barriers-care among patients with HF were categorized into three main categories, namely personal factors, disease burden, and inefficient support system. Each category had three subcategories which were respectively lack of self-care knowledge, heart failure-related negative emotions, the difficulty of changing habits, progressive physical decline, comorbid conditions, financial strain, inadequate social support, healthcare providers’ inattention to self-care, and limited access to healthcare providers. Conclusion: Patients with heart failure face different personal, disease-related, and supportrelated barriers to self-care. Based on these barriers, healthcare providers can develop interventions for promoting self-care among patients with heart failure.

Introduction: The Neck Bournemouth Questionnaire (NBQ) is being used widely in various countries. This study evaluated the validity and reliability of the Persian version of NBQ. Methods: This methodological study investigated 170 patients with chronic neck pain (NP). The psychometric properties of NBQ were evaluated in two stages. First, the standard scale was translated based on Guillemin’ s guidelines for cross-cultural adaption and face validity tested in a pilot group (N = 25). Second, it was conducted on a sample of 170 diverse chronic pain patients. Construct validity was determined with convergent validity by short-form McGill pain questionnaire. Then, the reliability was confirmed using Cronbach’ s alpha and the intraclass correlation coefficient. Results: The instrument demonstrated a good face validity and the participants made minor changes. A slight change was applied on content validity. In construct validity, Pearson’ s correlation coefficient was 0. 85, which was statistically significant and showed strong correlation. A Cronbach’ s alpha of 0. 87 was obtained. This confirmed the remarkable internal consistency and stability (0. 92). Conclusion: The Persian version of NBQ showed a good internal consistency and reliability and it could be considered as a valuable tool for assessing patients with cervical pain in Iranian population.

Introduction: Cancer-related fatigue (CRF) is one of the major problems experienced by cancer patients. Identifying the prevalence and factors associated with CRF may be effective in designing appropriate interventions to reduce this problem. This study aimed to examine the prevalence of CRF and its related factors among Iranian cancer survivors. Methods: The samples of this descriptive cross-sectional study included 131 cancer survivors referred to outpatient clinic of Shahid Gazi Hospital affiliated to Tabriz University of Medical Sciences. Brief fatigue inventory (BFI) questionnaire was used for data collection. The data were analyzed using SPSS software version 13, descriptive statistics, and regression analysis. Results: The mean (SD) fatigue score was 6. 41 (1. 68) and 89% of survivors reported that they had suffered from CRF. The factors affecting CRF included blood pressure, diabetes mellitus, anemia, serum levels of blood urea nitrogen (BUN), marital status, type of cancer, and physical activity. Conclusion: High level of CRF in cancer survivors requires special attention and designing effective interventions through considering the identified factors associated with CRF.

Introduction: After abdominal surgery, the patients who are separated from mechanical ventilation and provided with oxygen therapy via a T-piece are at risk for respiratory complications. Therefore, they need additional respiratory support. This study aimed to evaluate the effects of manual hyperinflation (MHI) on pulmonary function after weaning. Methods: This randomized clinical trial included 40 patients who had undergone abdominal surgery and were receiving oxygen via a T-piece. Patients were selected from the intensive care units (ICU) of two hospitals in Mashhad, Iran. The subjects were randomly allocated to intervention (MHI) and control groups. Patients in the MHI group were provided with three 20-minute MHI rounds using the Mapleson C, while the control group received routine cares. Tidal volume (Vt), Rapid Shallow Breathing Index (RSBI), and the ratio of arterial oxygen partial pressure to fractional inspired oxygen (P/F ratio) were measured before the intervention, as well as 5 and 20 minutes after the intervention. Atelectasis prevalence was assessed before and 24 hours after the intervention. Data were analysed by SPSS software version 13. Results: At baseline, there were no significant differences between the groups regarding Vt, RSBI, P/F ratio, and atelectasis rate. No significant difference was also found between the groups regarding atelectasis rate 24 hours after the intervention. However, at both posttests, Vt, RSBI, and P/F ratio in the MHI group were significantly better than the control group. Conclusion: In patients with artificial airway and spontaneous breathing, MHI improves pulmonary function.

Introduction: Depression is the most common psychological problem in patients with renal failure, and it can lead to mortality in severe cases. Effective interventions are required to promote mental health in patients on hemodialysis with various types of mental disorders. The current study aimed to evaluate the effect of emotional disclosure by writing on depression of patients on hemodialysis in Iran. Methods: This clinical trial study was carried out on 140 patients undergoing hemodialysis in hemodialysis centers of Kerman. Patients were randomly assigned into two groups of intervention and control after signing the written consent forms and completing the Depression Anxiety Stress Scale (DASS 21). The intervention group was requested to write daily the deepest emotions and intrusive thoughts within 15 to 20 minutes in four consecutive days. The control group received routine care. Then, the questionnaire was recompleted two weeks later. Finally, the data were analyzed by SPSS (version 13) using independent t-test and paired t-test. Results: The mean depression score was either moderate or high. While depression scores seemed to decrease in the intervention group after the intervention, the depression scores continued to rise following the intervention in the control group. The difference in depression scores was statistically significant between the two groups before and after the intervention. Conclusion: Emotional disclosure by writing can be effective on the level of depression in patients on hemodialysis. Simus adi omnimodipsa sam fugita dolenistiae inveles est doluptat

Introduction: Postpartum anxiety may be associated with depression, postpartum blues, and maternal mood disorders. This systematic review investigated the effects of music therapy on postpartum anxiety and pain levels. Methods: English databases including Cochrane, Medline, Embase, Web of Science, Scopus, and PubMed and Persian databases including Scientific Information Database (SID) and the Iranian Registry of Clinical Trials (IRCT) were searched. The data were analyzed in RevMan 5. 3 and reported as forest plots. The present study was conducted on postpartum women (i. e., the participants). All randomized controlled trials comparing the effects of music (i. e., the intervention) and placebo or routine care (i. e., the control) on postpartum anxiety and pain (i. e., the outcome) were included in the study. Results: Out of a total of 60 retrieved articles, four eligible articles were selected and entered the meta-analysis process. According to the results, anxiety (MD =-0. 68, 95% CI =-1. 90 to-0. 54, P < 0. 001) and pain (MD =-1. 85, 95% CI =-3. 96 to 0. 26, P < 0. 001) levels of patients in the music therapy group were reduced more significantly than those in the control group. Conclusion: The results showed that music therapy can significantly reduce both postpartum anxiety and pain scores. However, due to the high heterogeneity of the studies, more randomized trials using a standard tool such as the Consolidated Standards of Reporting Trials (CONSORT) statement are needed.