Medical-Surgical Nursing Journal
Year:2013 | Volume:2 | Issue:3-4|Papers Count:11

Background and Objective: Therapeutic touch is independent nursing intervention which is effective on nausea induced by chemotherapy but technique, steps and variables affected by this therapy are not yet well known. This research was done to introduce therapeutic touch steps by steps on nausea induced chemotherapy in breast cancer patients.Materials and Method: In this research, 108 patients were examined with intentional sampling and random allocation in 3 groups (control, placebo and intervention) in 2013 (each group 36). Intervention received therapeutic touch (touching of first energy layer) and demographic form, visual analogue scale (VAS) for intensity of nausea, check list for duration and times of nausea in the morning, noon, afternoon and night at acute phase were used. Data were analyzed by Kruskal Wallis, c2 and analysis of variance (ANOVA).Results: Kruskal Wallis test in comparison between the groups indicated that therapeutic touch is effective on times, duration and intensity of nausea showing that the whole process took place in 21.38 ± 6.04 minutes. In 69.4% reassessment and doing intervention was necessary. Steps of therapeutic touch also are introduced.Conclusion: Results of this randomized control trial showed that therapeutic touch is effective on duration, times and intensity of nausea; therefore, implementation of this technique by nurses is recommended.

Background and Objective: Balance disorder is one of the widespread problems in patients who suffer from multiple sclerosis (MS). Imbalance causes decline in performance independence, expansion of disability, and also increase in danger of falling. The present study aimed to investigate the influence of Tai Chi training program on balance of patients with MS.Materials and Method: The present study was a quasi-experimental on women aged 30 to 40 years with multiple sclerosis in 2012 admitted to the MS Society of Mashhad, Iran. The subjects of the present study were chosen through purposive and convenience sampling and then randomly assigned into experimental (n=15) and control groups (n=15). Tai Chi training program comprised of 8 weeks (3 sessions a week). Berg Balance Scale was used to measure the balance in MS patients. The obtained data were analyzed using dependent and independent t-tests.Results: the results showed that there was a statistical significant difference between the average points of balance in experimental and control groups (P<0.001). Therefore, the amount of balance in experimental group was significantly increased after the training phase (P<0.001). Whereas the control group did not show any statistical significant differences (P=0.136).Conclusion: Tai Chi exercises can lead to increase in balance and decrease in danger of falling in patients with MS.

Background and Objective: As a crucial component of nursing, the nature of nurse-patient relationship has been greatly influenced by the nursing care context. Thus, this study was done to explain the meaning of nurse- patient relationship in operating room to consider the unique nurse and patient situation in operating room.Materials and Method: A qualitative content analysis approach was done with 17 participants who were selected through purposive sampling. Participants were nurses, patients and patient relatives which conducted by 21 semi-structured interviews during 2011-2012 in Yazd hospitals. Interviews text was transcribed verbatim and analyzed using the conventional content analysis approach. Sampling ceased when data saturation was occurred.Results: The findings were manifested in one main theme as ‘reliance centered caring presence’. Under this theme, three subgroups were discussed i.e. "nurse-centered presence", "patient-centered presence", "and spirituality-based care".Conclusion: The findings of the study enhanced understanding of the meaning and dimensions of the nurse-patient relationship beyond the traditional meaning through the exploring the real and contextual meaning of this phenomenon. According to results, the concept of nurse-patient relationship in the operating room identified as a reliance-centered caring presence. This relationship is unique, but with the complexity and multidimensional nature. During this caring, the individual seeks help from trustful inner strength, effort, practice and policy. This finding needs further research.

Background and Objective: Admission in intensive cardiac care units (CCU) is potentially a stressful event that pain and physiological disorders of patients due to acute illness, with secondary affective disorders, may lead to the CCU syndrome or delirium. This study examined the impact of multifactorial interventions on the incidence of delirium in patients hospitalized to intensive cardiac care units in Shiraz, Iran.Materials and Method: In this study, a clinical trial was carried out on 120 patients (who were divided into two intervention and control groups) admitted to CCU of Shiraz's hospitals, during 4 months, in 2012. In the Intervention group, patients were allowed to listen to the radio and also family visits outside the visiting hours. And patients in the control group received the normal and routine CCU cares. During interventions cognitive impairment in samples assessed by using mini-mental state examination (MMSE), twice a day, and suspected cases, for incidence of delirium, confirmed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria. Data analysis was done by descriptive statistics and non-parametric tests.Results: Given the only incidence rate of 0.8% in control group, there was no statistically significant difference compared with the intervention group (P=0.315). However, the results showed a significant increase in cognitive scores in the intervention group after interventions (26.58 ± 3.46) compared with pre-intervention phase (24.70 ± 3.74) and with the control group (24.72 ± 3.72), (P=0.003).Conclusion: The applied intervention in this study did not affect on delirium incidence rate but considering the increasing of mean cognitive scores, it can be applied as a nonpharmacological and safe method in CCU patients to prevent incidence of delirium.

Background and Objective: Sleep disorder is a common problem in patients hospitalized in the critical care unit and nursing care interventions is among the external factors of sleep disorders. This study investigated the effect of strategies to moderate nursing care practices on admitted patients sleeping status in the coronary care unit.Materials and Method: This was a quasi-experimental and single blind study, during which 30 patients admitted to the coronary care unit of Shariati Hospital, Tehran, Iran, in 2011, through available sampling (n=60). Sleep quality and quantity was measured on the first day of admission and three days later, using questionnaire in the control group and also sleep quality and quantity of patients in the intervention group was measured with the same method but with a modified nursing care practices. Data analysis was done using descriptive and deductive statistics (chi-square, paired t and independent t-test).Results: The findings of the present study showed a statistical significant difference between sleep quality control and intervention groups in three nights of hospitalization (P<0.001); besides, the mean changes in sleep quantity before and after hospitalization in the intervention and control groups was statistically significant (P<0.001).Conclusion: Significant reduction in the quality and quantity of sleep in the intervention group compared to the control group admitted showed use of moderating nursing care practices can maintain unchanged sleep quality and quantity of patients admitted to coronary care unit.

Background and Objective: Patients with risk of myocardial infarction (MI) has prodromal signs like chest pain, dyspnea, fatigue or restlessness, tachycardia, syncope, and other informal signs. Recognizing the patients with prodromal signs is necessary, but determined rarely. Early diagnosis is important for emergency intervention and treatment results. This study was a descriptive-analytical study to determine the prodromal symptoms in patients with MI in cardiac care unit (CCU) of Imam Ali Ibn Abi Talib hospital in 2012 in Rafsanjan, Iran.Materials and Method: The subjects included 175 patients with acute myocardial infarction and selected in simple manner. For data collection (from July 2012 to February 2013) questionnaire was used, which included demographic data, risk factors for heart disease, and prodromal symptoms. For data analysism descriptive statistics (mean, standard deviation, frequency distribution and percentage) and chi-square test and Pearson coefficient were used.Results: According to the results, the majority of patients were males (76.6%) and middle-aged (53.1). Of 175 study subjects, 132 (75.4%) had warning sign two weeks before the cardiac event and 43 (24.6%) were without symptoms. The most common cardiac signs were chest, epigastria, and hand pain, in gastric signs loss of appetite, vomiting, in respiratory signs, dyspnea and in systemic signs exhaustion, decrease of daily activity and perspiration. There was no significant difference between the demographic variables and prodromal symptoms (P>0.05).Conclusion: The majority patients in the days before a heart attack have warning symptoms; most of them did not pay attention to the signs and did not refer to medical centers. Those who had warning signs, after acute myocardial infarction symptoms, were admitted to the hospital later. So increasing population knowledge via mass media is recommended.

Background and Objective: Anxiety and fear are the major children's emotional responses to hospitalization. In this regard, the use of non-pharmacological techniques to relieve anxiety is of paramount importance. The present research was conducted aiming to determine the impact of storytelling on physiological anxiety, concerns, and social anxiety of 7 to 10-yearold hospitalized children.Materials and Method: This clinical trial was conducted on sixty four 7 to 10-year-old children hospitalized in Ali Ebn Abi Taleb Hospital in Zahedan, Iran in 2013. The subjects were randomly divided into two groups. In the intervention group, the storytelling program was conducted. The control group received the routine measures in the ward. Anxiety was measured in the two groups on the first and sixth day of hospitalization. The data were collected through the Revised Children’s Manifest Anxiety Scale (RCMAS). Eventually, the data were analyzed using Chi-square and t-test.Results: Mean comparison of anxiety subscales in the control group showed that the physiological anxiety, anxiety and social anxiety had no statistically significant differences between the first and sixth day (P>0.05). However, comparison of the subscales in the intervention group showed statistically significant differences between the first and sixth day (P<0.001).Conclusion: The results showed high levels of anxiety in all the subscales during hospitalization in the control group. Storytelling could reduce all the aspects of physiological anxiety, worry anxiety and social anxiety subscales. Therefore, storytelling is recommended to be used as a non-pharmacological, easy, affordable, accessible and children’s favorite method. This research can introduce storytelling as a creative and new approach into the care and treatment arena in pediatric wards.

Background and Objective: Cesarean section is the most common surgeries in women. Hemodynamic changes after cesarean can improve maternal recovery and quick contact between mother and infant delay. The aim of this study was to determine the effect of music therapy on patients' blood pressure and pulse undergoing caesarean section surgery.Materials and Method: In this experimental study, 60 patients underwent elective caesarean section, in Hakim Jorjani Hospital in Gorgan, Iran enrolled into the study in 2011 by convenience method, and were randomly allocated into two groups (30 in experimental and 30 in control group). Classical music for 15-20 minutes for experimental group was played. Blood pressure changes and pulse time before the intervention, initial surgery, immediately after anesthesia, 15 and 30 minutes after the consciousness and time out recovery were measured and compared for the two groups. The data were analyzed by repeated measure ANOVA and analytical and descriptive statistical tests.Results: The findings showed in the two groups, there was a statistical significant difference between the diastolic blood pressure (P=0.045) and pulse changes (P=0.036). Therefore, in the intervention group, rate of change were less than the control group. Results from systolic blood pressure changes between the two groups did not show any statistical significant difference (P=0.610).Conclusion: Results showed that music therapy in women undergoing cesarean section before entering the operating room could alleviate hemodynamic changes of post surgery, thus it can improve patient recovery and early contact of mothers with their infants. Therefore, this therapeutic method is essential to be considered by physicians, nurses and other healthcare givers.

Background and Objective: Family plays an undeniable role in the behavior and lifestyle of patients. Family-centered empowerment is a model that is currently used in order to improve life quality and change the lifestyle of patients. Since lifestyle is of great importance to hypertension, this study aimed to determine the effect of family-centered empowerment model on the lifestyle of patients with hypertension.Materials and Method: This semi-experimental study was done on 67 patients who visited Qaen therapeutic sanitary centers in 2013. Having selected persons who met entry criteria to the study, the participants were randomly divided into a control group (n=35) and an experimental group (n=32). During 2.5 months and within 6 sessions, the experimental group went through a family-centered empowerment model with the four dimensions of perceived threat, self-efficacy, educational partnership, and evaluation; the control group received the usual care. The data were collected by a researcher-made questionnaire and analyzed usingt test, independent t, Wilcoxon and Mann-Witney tests.Results: Mean lifestyle score was 106.71 before and 135.04 after the intervention in the experiment group. Paired t-test showed a statistical significant difference between the lifestyle overall score and lifestyle dimensions before and after the intervention (P<0.05). Furthermore, independent t -test showed a significant difference between the overall lifestyle score of the experiment and control groups after the intervention (P<0.001).Conclusion: In general, performing family-centered empowerment model is effective on lifestyle change in patients with hypertension.

Background and Objective: Anxiety effects on function in all organ’s especially on respiratory system and adverse effects in patients with chronic obstructive pulmonary disease (COPD) has more negative effects. Therefore this study was conducted due to the high rate of patient with COPD and need of safe and non-invasive way in nursing care to reduce anxiety in patients.Materials and Method: This randomized controlled trial was done on 40 patients with COPD in two groups of foot reflexology and one control group in Imam Reza Hospital, Tabriz, Iran in 2012. In the intervention group, the foot massage was done for 30 minutes once a week for 6 sessions. General form of the Spielberger anxiety score was filled once before starting and once after the last session of the intervention by all the patients. Data were analyzed using paired t-test and chi-square test.Results: The anxiety level of participants in the intervention group 63.3 ± 6.7 to 54.8 ± 5.5 and the control of 65.0 ± 6.1 to 64.8 ± 5.8 have been reduced. In the intervention group, this difference was statistically significant (P<0.001).Conclusion: According to the results of this study, it can be concluded that foot reflexology can be used easily and as a safe method in nursing intervention to reduce anxiety in patient with COPD.