Medical-Surgical Nursing Journal
Year:2015 | Volume:3 | Issue:4|Papers Count:8

Background and Objective: Presence is an essential aspect of any nursing care situation and is provided by considering the overall needs of the patients and lead to their comfort and health. Heart disease is a stressful experience for many patients that are associated with unwanted fear that can create a lot of needs and tension. Nurse can recognize and solve the caring needs of patients through an effective presence. Therefore, this study was conducted aimed to explain the experiences and perceptions of cardiac intensive care patients concerning the nurse presence.Materials and Method: This study was conducted with a qualitative, conventional content analysis approach. The participants were 15 cardiac patients which were selected through purposive sampling. Data collection was performed by unstructured interviews. Data collection continued until data saturation. Continuous analysis of data was performed simultaneously with data collection and through a comparative method.Results: From data analysis three main themes emerged including "Patient's comfort with continuous monitoring of the nurse with the sub-themes; (ongoing watch, attention and follow-up the provided care); humanistic and responsibly relationship of the nurse with the sub-themes; (committed and respectful encounter of nurse, Patience and empathy), and understanding the nurse supporting with the sub-themes; (receiving the necessary information and education, and easy access to the nurse).Conclusion: The real presence of nurses is source of comfort and provides the patients needs. So it is recommended that the clinical nurses and managers with relying on these findings design the caring activities so that the nurses’ presence act as a facilitated factor in recovery process of patients.

Background and Objective: Improving the self-efficacy of chronic patients is necessary to achieve self-management and behavioral changes. Thus, the present study was aimed to evaluate the effect of the continuous care model on the self-efficacy of patients with myocardial infarction.Materials and Method: This quasi-experimental study was conducted in 2014 on patients with myocardial infarction referring to Valiasr Hospital of Birjand, Iran. The 70 participants were selected using convenient sampling method and randomly assigned to two groups of control and intervention. Due to loos of subjects, the study was performed on 60 subjects. The continuous care model was implemented in intervention group. The control group received routine care. Patients' self-efficacy was assessed using the Chronic Disease Self-Efficacy Scale. The obtained data were analyzed using paired t-test, Student's independent t-test, analysis of covariance (ANCOVA), one-way ANOVA, and SPSS software version 16. All P values below 0.05 were considered statistically significant.Results: The 2 groups showed no significant differences in terms of gender, marital status, education, and time since diagnosis of illness. The mean self-efficacy scores of control group subjects before and after the intervention were 5.90±1.79 and 5.27±1.79, respectively. The mean self-efficacy scores of the intervention group subjects were 5.98±1.36 and 6.81±0.19 before and after the intervention, respectively. The intervention group subjects reported higher mean scores of self-efficacy than control group subjects after the intervention (P<0.001).Conclusion: Regarding the chronic nature of myocardial infarction and its complications, continuous care model is an important step to enhancing self-efficacy and making behavioral changes among patients with myocardial infarction. Therefore, patient education by nurses can be an effective factor in improvement of patients’ performance and community health and indicative of the importance of nurses’ role. Thus, the use of this model in order to increase self-efficacy in patients with myocardial infarction is recommended.

Background and Objective: One of the major issues in hemodialysis patients is adherence to diet and fluid restriction. In order to reduce the adverse consequences of the disease and improve quality of life, educating these patients is of great importance. Therefore, the present study was conducted in order to compare the impact of two methods of education (patient-centered and family-centered) on attitude toward and adherence to diet and fluid restriction in hemodialysis patients.Materials and Method: This clinical trial was performed on patients referred to the hemodialysis ward of hospitals affiliated with Tehran University of Medical Sciences, Iran, during May to October 2012. Through purposive sampling method, 60 patients were selected and randomly assigned to two groups; patient-centered (n=30) and family-centered (n=30). Patients’ attitude toward and adherence to diet regime and fluid restriction were assessed using a researcher-made self-report questionnaire in 3 stages (before the intervention, and 2 and 4 weeks after the intervention). The reliability and validity of the questionnaire were approved. Data analysis was performed using SPSS software version 16 and independent t-test, chi-square, Fisher’s exact test, and repeated measures ANOVA.Results: Before the intervention, the findings showed no significant difference between the 2 groups in terms of adherence to diet and fluid restriction. In the second week after the intervention, mean adherence to diet in the family-centered group was significantly higher than the patient-centered group (P = 0.010). Moreover, at the end of the second (P=0.001) and fourth weeks (P=0.002), the attitude toward adherence to diet and fluid restriction was more positive in the family-centered group, in comparison to the patient-centered group.Conclusion: Family-centered education is more effective on patient adherence to the treatment regimen. Thus, it is recommended that family-centered educational interventions be performed.

Background and Objective: Today, the control or reduction of pain and anxiety is considered to be of great importance. Thus, the use of complementary medicine therapies has gained much attention. The present study was performed with the aim to investigate the effect of music on anxiety and pain in patients undergoing cholecystectomy.Materials and Method: This single-blind randomized clinical trial was performed on 60 patients undergoing cholecystectomy in Sina Hospital of Tabriz, Iran, in 2013. Subjects were selected through simple random sampling method and divided into intervention (n=30) and control groups (n=30) using a random number table. For the intervention group, 8 and 16 hours after surgery, the music was played for 15-30 minutes. For the control group, routine care was performed. Data collection tools included demographic information form and a visual analogue scales (VAS) for anxiety and pain. Data analysis was performed using SPSS software version 13, and chi-square, Students’ independent t-test, and repeated measures ANOVA.Results: Comparison of changes in anxiety and pain in the two groups showed a significant decrease in anxiety 8 hours (6.27±3.23) and 16 hours (5.33±3.03) after surgery (P=0.001). Moreover, the reduction in pain 8 hours (7.51±1.83) and 16 hours (6.61±1.86) after surgery was greater in the intervention group than the control group (P=0.001).Conclusion: The results illustrated the positive impact of music on anxiety and pain reduction 8 and 16 hours after cholecystectomy. Therefore, this method can be used as an inexpensive and non-invasive nursing care technique.

Background and Objective: Responding to holistic needs of patients can reduce anxiety. The purpose of this study was to determine the effect of holistic cares with family participation on attitude and preoperative anxiety of patients.Materials and Method: This quasi-experimental study was conducted on all patients undergoing prostate surgery during 2012 at Emam Reza Hospital, Birjand, Iran. Therefore, 68 patients were assigned randomly to two groups of 34. In the intervention group, prior to each preoperative care needs of patients, such as covering the body, were determined through 5 questions and cares were provided accordingly with family participation. The control group received routine cares. Intervention outcomes were the scores of attitude and anxiety of patients. The attitude toward preoperative cares was measured using a 10-item researcher-made questionnaire at admission and before hospital discharge. Anxiety and preoperative information were measured using the Amsterdam Preoperative Anxiety and Information Scale at the beginning of hospitalization and before surgery. Data were analyzed using SPSS software version 16 and chi-square, and independent and paired t-tests.Results: Total score of mean attitude toward preoperative cares of the intervention group (42.44±8.07) was higher than the control group (36.82±9.32) (P=0.01). Furthermore, the total mean preoperative anxiety score of the intervention group (14.08±2.72) was lower than the control group (16.02±1.56) (P<0.001) and had reduced compared with pre-intervention (15.32±2.60) (P<0.001).Conclusion: Providing preoperative holistic cares with family participation was effective in creating positive attitude and reducing anxiety in anxious patients. Thus, its use is recommended in providing all medical and nursing cares.

Background and Objective: Cardiopulmonary resuscitation (CPR) is performed in order to restore the functioning of two most important body organs; the heart and brain. The present study was performed to investigate the effect of retraining of nurses on CPR success rate and short-term and long-term CPR survival.Materials and Method: The study population of the present quasi-experimental study consisted of all nurses of Taleghani Hospital affiliated with Shahid Beheshti University, Tehran, Iran, in 2011. The study subjects (n=400) were selected using convenience and purposive sampling method. The patient survival rate during the first 24 hours (short-term survival) and discharge from the hospital (long-term survival) after CPR were reported. Then, the study subjects, in groups of 20, participated in CPR training courses. Short-term (24 hours) and long-term (discharge from hospital in good mental status) survival subsequent to CPR were reevaluated and compared with pre-training results. Data were analyzed using SPSS software version 20, and t-test and chi-square test.Results: Retraining promoted CPR success rates. This increase in the short-term success rate was not significant, but the increase in long-term success rate was statistically significant (P=0.007).Conclusion: Periodic retraining of nurses may improve CPR success rate particularly long-term survival or discharge from hospital. Therefore, further studies on long-term success of CPR considering confounding factors are recommended.

Background and Objective: The receipt of appropriate and safe health care is of the basic rights of patiants and its provision is the main task of the health care delivery system. The role of error reporting in the reduction of future occurrence of that error is undeniable. Therefore, the removal of barriers to error reporting has particular importance. The present study aimed to investigate the association between patient safety climate and barriers to reporting of nursing error in Social Security Hospitals in Kerman province, Iran.Materials and Method: This was a cross-sectional, descriptive-correlative study. The study population consisted of all nurses of Social Security Hospitals in Kerman in 2014. Sampling was performed using the census method (n=233). The Patient Safety Climate Questionnaire and Barriers to Nursing Error Reporting Questionnaire were used after obtaining satisfactory reliability and validity. Data were analyzed using SPSS software version 16 and frequency distribution tables and central indices. To achieve goals, the parametric test of t-test, one way ANOVA, and Pearson correlation coefficient were used.Results: The mean and standard deviations of the safety climate score (66±10) and the barriers to nursing error reporting score (69±13) were obtained: both were at a medium level. A significant inverse relationship was observed between patient safety climate and barriers to error reporting (P<0.020) (r=-0.15).Conclusion: Based on the results, the error reporting barriers and safety climate scores were at an average level. Given the inverse relationship between safety climate and barriers to reporting error, it can be concluded that the most important step toward removing barriers is creating an atmosphere in which each of the nursing staff voluntarily reports her/his error and its causes to other members of the treatment team.

Background and Objective: Multiple sclerosis (MS) is a chronic and progressive disease of the central nervous system. The identification of effective factors and patient education on the prevention of exposure to these factors can be effective in reducing relapses. Therefore, the present study aimed to investigate the factors that affect recurrence in patients with multiple sclerosis.Materials and Method: This cross-sectional study was conducted on 402 MS patients referred to the MS Association of Mashhad, Iran, in 2013. The study participants were selected using purposive sampling method. Data collection tools included a demographic questionnaire and a 40-item researcher-made questionnaire concerning factors affecting the recurrence of MS. The 40-item questionnaire consisted of 4 domains; personal factors, medical condition, pharmaceutical conditions, and environmental factors. Data analysis was performed using SPSS software version 21 and Mann Whitney, Pearson correlation, Kruskal Wallis, and chi-square statistical tests.Results: Among the patients, 21.4% were male and 78.6% female. Most patients were 20-29 years old. The highest prevalence of recurrence of MS was observed in the summer (70.8%) and in August (50.3%). There was no significant relationship between patient’s gender and their views about the relationship between infections, fatigue, and heat and recurrence of MS. However, a higher rate of women believed stress (P<0.029) and sexual development (P<0.001) to be effective on the incidence of MS recurrence, in comparison to men.Conclusion: Most patients with MS are women, and they believe stress to be more effective on the incidence of MS attack recurrence. Therefore, nurses, as the primary care educators, can improve the patients’ capability, disease management, and quality of life through training of stress management techniques.