Medical-Surgical Nursing Journal
Year:2016 | Volume:4 | Issue:4|Papers Count:8

Background and Objective: With regard to the multi-dimensional and complex nature of chronic pain management process in the elderly, the identifying of its various aspects is essential for proper management of this type of pain. The current study aimed to explain the chronic pain management process in the elderly.Materials and Method: This study was conducted based on grounded theory approach in health care centers of Ahwaz in 2013-2014. Participants including 62 persons consisted of 30 elderly people who were confirmed about the lack of cognitive disorders through using I.V.A.M.T.S , 3 persons of their relatives and 29 persons of health care providers. Data collection was done through using semi-structured interview, observation and field note. Data analysis was performed based on Strauss and Corbin’s method of analysis.Results: Data analysis showed that the “comprehensive support” is considered as an important and facilitating factor in the process of chronic pain management in the elderly which consists of four sub-categories as “being with family”, “team work”, “targeted treatment” and “social support”.Conclusion: Chronic pain Management in the elderly will not be achieved without helping of effective supportive resources. Making appropriate decisions can be effective in order to identifying and gaining support from these sources for effective management of pain.

Background and Objective: Weaning from mechanical ventilator due to the direct effect on patient’s physiologic indices is very risky action and if it is unsuccessful, it can lead to reintubation of patient. The aim of the current study was to compare the effect of two weaning methods from mechanical ventilation “SBT” method with “SIMV” on physiological indices of ventilated patients.Materials and Method: In this clinical trial study, 44 intubated patients in intensive care units of one of the hospital in Arak in 2014 were selected through convenience sampling and then were randomly allocated into two intervention and control groups (each group 22 persons). In intervention group SBT method and in control group SIMV were used as weaning method from ventilation. Data collection was done thorugh using physiological indices and GCS score before, during and after the intervention Data were analyzed by using SPSS 20, paired T-test, independent T-test, repeated measures ANOVA and Greenhouse-Geisser.Results: In SBT group, the means of systolic blood pressure was (107.90±5.2), heart rate (70.27±7.2), respiration rate (14.90±1.06) had significant reduction after intervention (from 9 to 12 Am) (p<0.001). Also, the mean of Pao2 (89.12±1.16), mean of diastolic blood pressure (76.09±4.6), O2 sat (93.09±0.97) and level of consciousness (14.90±0.21) had significant increase after intervention and physiologic status of patients was improved. In control group there was no significant difference among the measured indices.Conclusion: The results showed that “SBT” method leads to improvement of systolic and diastolic blood pressure, heart rate, Pao2, O2sat and level of consciousness of patients in intervention group. It is recommended to apply of this weaning method in intensive care unit.

Background and Objective: Today more than ever, the importance of health promoting behaviors is considered. Maintaining the function, independence and increasing the quality of life of chronic patients such as hemodialysis patients is influenced by health promoting behaviors. The current study was conducted to determine the effect of education of health promoting behaviors on the quality of life in hemodialysis patients.Materials and Method: In the current quasi-experimental study, 70 hospitalized patients were selected through convenient sampling in hemodialysis wards of two Therapeutic-Educational Centers in Hamadan in 2014. Then, the subjects were randomly allocated into two intervention and control groups of 35 persons. In intervention group, 6 educational sessions were held during the hemodialysis. Quality of life of patients in two groups was measured through Ferrans and Powers Quality of Life Index-dialysis version before and three months after the intervention. Data were analyzed in SPSS 16, and using chi-square test, independent T-test and paired-T test.Results: In intervention group, the mean score of quality of life after intervention was changed from 18.85±5.4 to 20.11±5.46 (p<0.001) and in control group from 19.41±4.67 to 18.39±4.10 (p=0.08). After intervention, quality of life of patients in intervention group was increased in health and functioning domain (18.6±5.7) (p<0.001) and was increased in psychological/spiritual domain to 19.3±7.02 (p=0.041).Conclusion: Education of health-promoting behaviors improved the quality of life of hemodialysis patients. Therefore, according to chronic nature of disease, the education of these behaviors can be effective in improving the quality of life.

Background and Objective: Providing safe care is one of the nursing goals and medication error is considered as one of the threatening factor for patient safety. The current study was conducted to determine the relationship between the medication errors and nurses’ work environment.Materials and Method: This is a cross-sectional and correlation study. Study population was including the nurses working in hospitals affiliated to Tehran University of Medical Sciences in 2012. 300 nurses were selected through stratified sampling method.. Data were collected by demographic questionnaire, Nurses Work Environment scale and medication errors researcher-made questionnaire. Data were analyzed through using SPSS16, Pearson’s correlation coefficient, Kruskal–Wallis and Independent t-Test.Results: The mean score of medication errors of nurses was (15.12±4.14) and the mean score of nurses work environment index was (67.34±5.6). Most types of reported medication errors concerning the frequency of them were respectively as medication later or earlier than scheduled (24 percent), lack of necessary measures before the medication (17.4 percent), non-compliance with medication right time (10.9 percent). Nurse-physician relationship was reported as the most adverse aspect in context of work environment. There is a significant inverse relationship between the occurrence of medication errors and conditions of nurses work environment (p<0.016) (r=-0.8).Conclusion: Based on the study results, whatever the nurses working conditions are more desirable, the amount of medication errors is lower. Thus, it is essential to application of effective strategies by managers for improving work conditions and consequently providing safe care of patients.

Background and Objective: Patients with loss of consciousness experience pain concerning the invasive procedures, mechanical ventilation and physical situation of ICU. The current study was conducted to determine the effect of music on pain intensity in patients with loss of consciousness in intensive care unit.Materials and Method: In this clinical trial study, study population was the intubated patients under mechanical ventilation who hospitalized in intensive care unit in one of the hospitals in Zahedan, 2015. Sixty eligible patients were selected conveniently and then were randomly allocated through permuted blocks into two music therapy and control groups of 30 persons. Intervention was carried out through playing instrumental music of Arnd Stein in 3 sessions of 30 minutes via headphone. Control group only received the routine care about pain relief. Measuring the pain was done through BPS, 5 minutes before and immediately after the music therapy. In control group, measurement was done with the same interval and frequency. Data were analyzed using independent T-test, paired T-test, chi-square and ANCOVA by SPSS 15.Results: Every three days after the intervention, the mean score of pain was significantly reduced in intervention group (p<0.0001). This difference was significant between the intervention and control groups (p<0.0001), while this difference was not significant in control group.Conclusion: According to results, the application of music can reduce the intensity of pain in patients with loss of consciousness. Thus, it can be used as a simple and practical method in pain relief.

Background and Objective: Cancer is a common disease in children. Chemotherapy as one of the most important treatments for cancer, can lead to anxiety and negative physiologic reactions. The current study aimed to determine the effect of foot reflexology massage on vital signs and anxiety related to chemotherapy drug injection in children with leukemia.Materials and Method: The current randomized clinical trial study was conducted on children of 6-12 years old with leukemia undergoing chemotherapy reffered to oncology center in Kerman in 2015. One hundred and twenty children were recruited by convenience sampling and were randomly allocated into three groups of 40 persons. The intervention was done as a 20-minute session of foot reflexology massage for intervention group and simple touch for the placebo group immediately before the injection. The vital signs and anxiety of patients were measured immediately before and after the intervention through using the vital sign record form and Observational Scale behavior Disress. The data were analyzed using Kruskal-Wallis tests, Chi-square, Wilcoxon, Mann-Whitney and Spearman correlation coefficient by SPSS 16.Results: After the intervention, systolic and diastolic blood pressure, heart rate, respiratory rate, temperature (p<0.0001) and anxiety (p=0.003) was significantly decreased in the intervention group. This decrease in the placebo group was significant only in the systolic blood pressure (p<0.0001), heart rate (p<0.0001), respiratoy rate (p=0.009) and anxiety (p<0.0001). While in the control group, the systolic blood pressure (P<0.03) and diastolic blood pressure (p<0.0001) was a significant increase after intervention.Conclusion: Foot reflexology massage as a non-pharmacological method can reduce anxiety and improve the vital signs in children with leukemia, during the chemotherapy drug injection.

Background and Objective: Poor sleep quality is one of the common problems in patients with myocardial infarction that can affect on quality of life in these patients. The current study aimed to determine the effect of jaw relaxation on sleep quality in patients with myocardial infarction.Materials and Method: This study was a quasi-experimental study. Population was the patients with myocardial infarction reffered to hospitals in Saveh in 2015. Patients were selected through purposive sampling (68 Person) and were randomly allocated in to two groups of intervention and control. Patients in intervention group perform the jaw relaxation techniques 5 times a day for 20 minutes and for a month. While the patients in the control group only received routine treatment. The data were collected through using the individual characteristics form and the Pittsburgh Sleep Quality Index before and 1 month after the intervention. The data were analyzed using Fisher's exact tests, chi-square, paired t-test and independent t-test by SPSS 19.Results: The mean scores of quality of sleep before the intervention in intervention group was (14.52±1.39) and in the control group was (14.32±1.29), while after the intervention these values was reduced respectively to (12.38±1.49) and (14.02±2.4) (p=0.001). According to independent T-test, there was a significant difference between the two groups (p=0.001).Conclusion: The results showed that the use of jaw relaxation techniques improves the sleep quality in patients with myocardial infarction. Due to the simplicity and low cost of this method, it can be used as a non-pharmacological method.

Background and Objective: Patients undergoing coronary angiography suffer from anxiety and worry for various reasons. This leads to changes in hemodynamic indices. The current study aimed to compare the effect of peer education and orientation tour on the hemodynamic indices in patients candidate for coronary angiography.Materials and Method: In this quasi-experimental study, population was the patients candidate for coronary angiography who referred to selected hospital of AJA University of Medical Sciences in 2014-2015. 177 patients were selected through convenience sampling and were randomly assigned into three groups of peer education, orientation tours and control.(each group of 59 persons). The patients were trained in angiography unit by peer in the peer education group, and by researcher in the orientation tour group. Hemodynamic indices of patients were measured and recorded 2 hours after admission and two hours before angiography. Data were analyzed through using SPSS 21, Chi-square test, one-way ANOVA and Paired t-test.Results: After intervention in peer education method, the systolic blood pressure (p=0.01), diastolic blood pressure (p=0.05), respiratory rate (p=0.03) and heart rate (p=0.001) was significantly reduced. All of these indices was significantly reduced in orientation tour group (p=0.001), while in the control group, all of the hemodynamic indices increased (p=0.001). After the intervention, there was a significant difference between intervention and control groups (p = 0.001).Conclusion: The peer education and orientation tour can lead to reduction of hemodynamic indices of patients candidate for coronary angiography; therefore, the application of these training approaches is recommended.