Medical-Surgical Nursing Journal
Year:2013 | Volume:2 | Issue:1-2|Papers Count:10

Background and Objective: Kidney transplantation is considered as selective and the most effective alternative way in treatment of patients with end-stage renal disease. Transplantation may improve patients' life quality, but it can also lead patients to face new challenges and concerns. Since there is little information about coping process of patients with renal transplantation, understanding how they cope with transplanted kidney may help health care providers to plan and implement appropriate and holistic care programs. The aim of this study was to explain the coping process in renal transplant recipients.Materials and Methods: A qualitative method with grounded theory approach was used to explain renal transplantation coping process. First, participants were selected based on purposive sampling and among renal transplant recipients.this process continued gradually by theoretical sampling. 11 renal transplant recipients in Afzalipour hospital, Kerman, Iran, and 3 family members were interviewed (n=14) during 2011-2012. Data analyzing was done followed guidelines proposed by Strauss and Corbin (1998).Results: Three categories emerged from data analysis including "perceive reality of transplantation", "contrastive strategies" and "learning challenging life". Results demonstrated transplanted kidney coping was a slow and steady process with special characteristics in each step. The main theme emerged from the text was continuous and purposive struggling to reach calmness in new life.Conclusion: Understanding the reality of transplantation and its challenges had either temporarily or permanently effects on patient’s life. In this process, nurses as important members of health care team can provide appropriate educational programs and supportive care in order to assist patients to learn how to cope with transplanted kidney and its challenges.

Background and Objective: Sleep disturbance can negatively affect the quality of life of older adults. Nowadays, complementary and alternative medicine is commonly used to treat insomnia in old aged ones. The aim of the present study was to determine the effect of reflexology on improvement of sleep quality in elderly.Materials and Methods: This was a single-blind controlled clinical trial on 46 men at the age of 65-70 years in Tabriz, Iran. Participants were randomly divided into two equal groups. One group received reflexology (intervention) and the other did not (control). The intervention was performed for each leg once a week in the mornings and for 10 minutes. The study measurement tool was the Pittsburgh Sleep Quality Index completed before and after the intervention by the researcher assistant. Data were analyzed using Wilcoxon and Mann- Whitney tests.Results: There was no significant statistic difference among the questionnaire components except for “sleep duration” (P=0.01) between the two groups. Comparing pre- and postintervention scores, the differences between two items of the questionnaire, “subjective quality of sleep” (P=0.029) and “delayed sleep phase” (P=0.001), were statistically significant.Conclusion: According to the study results, the maximum effect of the intervention was on subjective sleep quality and sleep duration disorders. We faced limited access to the elderly in all areas of Tabriz; therefore, study could be conducted in health centers in future research.

Background and Objective: cardiovascular diseases are among the most common causes of death all around the world. Assessment of cardiovascular system is a key component in nursing skills and evaluation of this skill has a critical role in assurance of the care quality. This study aimed to assess the nurses' self-evaluation about cardiovascular assessment skills.Materials and Methods: This cross-sectional study was conducted on 200 nurses working in Isfahan province hospitals, Iran, in the first two months of 2013. A multi-stage method was used for sampling. Data was collected by a researcher-made questionnaire with two parts: the first included demographic data and the second included 18 skills in cardiovascular assessment that were self-rated in terms of frequency of using and the level of proficiencyin skills. Statistical analysis was conducted using ANOVA and Independent t tests via SPSS11.5 software.Results: The nurses’ use of cardiovascular assessment skills was undesirable (39.97% of total score). In addition, their proficiencyin skills was at the lower border of desirable condition (52.12% of total score). Heart rate assessment was performed at highest frequency where 65% of nurses performed it every day. The lowest using rate was related to Trendelenburg test where 77% of nurses never performed it. The highest level of proficiency was in assessing heart rate reported by 68.5% of nurses; and the lowest was in assessing hepatojugular reflex and Trendelenburg test that 54.5% of nurses reported that could not perform them.Conclusion: The level of nurses’ proficiency in the skills of cardiovascular health assessment and their application in clinical settings was not satisfactory. This condition should bring attentions to the retraining programs and strengthening the supervisory system.

Background and Objective: Anxiety influences the patient's physiological reactions and makes him/her in danger in angiography room. The purpose of this study was to determine the impact of aromatherapy on the hemodynamic condition of patients experiencing coronary angiography.Materials and Methods: This clinical trial study was performed on 96 patients hospitalized for coronary angiography in Sari Fatemeh-Zahra hospital, Iran. They were selected based on purposive sampling and randomly divided in to control (n=46) and intervention (n=45) groups. The two groups in terms of gender, marital status, educational level, history of disease, age and having health insurance were matched. The collecting data tools consisted of demographic questionnaire and hemodynamic variables recording sheet, blood pressure gauge and chronometer. The questionnars was filled out for both groups before and after aromatherapy. The collected data were analyzed via SPSS16 using chi-square, t and Repeatedmeasurment ANOVA tests.Results: The systolic blood pressure, pulse ratye and respiration rate variables showed significant reduction after the aromatherapy in interventional group compared to controls. Although, there was no significant differences between the groups regarding other variables, but from clinical prospective, most of the variables showed more desirable condition in interventional group than in control group.Conclusion: According to findings of this study, using aromatherapy before stressful situations, like diagnostic technics, could be suggested to keep vital signs in normal range.

Background and Objective: Patients under hemodialysis treatment face various physical and mental problems. Since individual's compatibility in hard conditions of life increases with high self-efficacy, this study aimed to determine the effect of life quality training on self-efficacy in patients under hemodialysis treatment.Materials and Methods: In this research clinical trial study, was conducted on 90 patients under hemodialysis treatment (45 ones in each group) who were selected randomly among patients referred to dialysis centers of Kerman city, Iran. The data collection instrument consisted of demographic questionnaire, SUPPH (Strategies Used by Patients to Promote Health) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) instrument which were categorized to 3 levels, high, medium and low. The data were collected in two steps, before and two months after training intervention. The data were analyzed by SPSS 15, Chi-square, Paired t and Independent t tests.Results: There was no significant difference in life quality and self-efficacy between the two groups before training but after training, the quality of life (P=0.001) and self-efficacy (P=0.001) increased in intervention group.Conclusion: The results of research show that life quality training program affects self-efficacy of patients under hemodialysis treatment. So, it is recommended that life quality training programs become as care programms in hemodialysis units.

Background and Objective: Skin to skin continuous contact between mother and neonate, induced by the first breastfeeding, is the fourth of the ten steps for successful breastfeeding during one to two hour of birth that lead to express early breastfeeding behaviors. The present study aimed to evaluate the effect of two methods of crawl and routine breastfeeding on behavior of breastfeeding during two hours after delivery.Materials and Methods: This clinical trial study was performed on 60 women in Imam Ali hospital, Zahedan, Iran, during 2009-2011. Participants were selected by purposive sampling and were randomly divided in two groups of crawl and routine breastfeeding. In crawl group, the neonate immediately after birth (before all of interventions) lied on mother's skin between breasts and abdomen for 60 minutes to start breast crawl without helping. In routine group, the neonate only lied on mother's skin between breasts and abdomen for 15 minutes. Then, in both groups the neonate was wrapped and closed to mother to be breastfed under the nurse supervision. During this time, 6 items of breastfeeding early movement and 4 items of successful breastfeeding behavior were evaluated by infant breastfeeding assessment tool (IBFAT) scale; mother's satisfaction of skin contact with neonate was recorded according to numeric scale (0-5). The data were analyzed by SPSS 15, Indepentat t and Mann-Whitney.Results: 4 successful breastfeeding behavior items (P<0.001), and four breastfeeding early movement items (P<0.001) were significantly better in crawl group. Skin sense satisfaction was significantly higher in crawl (4.37±0.62) than routine (1.93±0.85) group.Conclusion: According to our findings, crawl method was more effective than routine method regarding young mothers' satisfaction, this method can be recommended to promote successful breastfeeding.

Background and Objective: Coronary artery bypass graft (CABG) surgery is one of the treatment methods for heart diseases developed and followed enormous costs recently. The present study assesseted the changes of life quality in patients undergoing coronary artery bypass graft surgery in year.Materials and Methods: This cross-sectional study was conducted on 60 patients undergoing coronary artery bypass graft surgery of Uremia Emam Khomeini hospital, Iran, during 2009- 2010. They were selected base on purposive sampling. Quality of life in patients in three parts of physical, social and psychological domains was evaluated before surgery and six months and one year after surgery by a researcher-made questionnaire (according SF36). The data were analyzed by SPSS 13, ANOVA and t tests.Results: The finding showed that the intermediate level of patients' life quality domains. Assessing the patients’ life quality in three times showed that statistically significant improvement in the physical (P=0.002) and psychological (P<0.001) domains except the social dimension (P=0.680). Total score of life quality increased significantly (P=0.004).Conclusion: The results of study indicated that total score of patients'life qualityincreased significantly during a year.

Background and Objective: Burn wound is of the health problems in modern societies associated with irreparable harms and many side problems for patients and their families. Pain is one of the primary results of the burn wound and pain relief is a basic need and right of all patients. This study aimed to evaluate and compare the effect of palliative dressing with silver sulfadiazine 1% cream and fundermol herbal ointment.Materials and Methods: In this clinical trial study in 2010, using convenient and continuous sampling method, 50 patients referred to Imam MousaKazem Burn Injury Clinic in Isfahan, Iran, with second-degreeburn wounds were enrolled. The patients were randomly divided into two groups of treatment with dressing with fundermol or sulfadiazine. Pain intensity was measured using a standard visual analog scale (VAS). The data analysis consisted of descriptive and inferential statistics USING Chi-square, Mann-Whitney, and Wilcoxon tests.Results: In the group treated with fundermol, the pain intensity significant decreased after the treatment (2.87±0.39) compared to before (4.87±0.25) it (P<0.001). But, in silver sulfadiazine 1% group, the pain intensity did not differ statistically after the treatment (4.88±0.26) compared to before (5.01±0.19) it (P=0.213). Post-treatment pain intensity difference between the two groups was statistically significant (P=0.001).Conclusion: According to the results, using the fundermol herbal ointment to cure and relieve the pain of second-degree burns is recommended.

Background and Objective: Hemodialysis is the most common renal replacement therapy in patients with end-stage renal disease. Although this method increases survival rate and life expectancy, but this patients face with many problems such as sleep disorder and restless legs syndrome. The present study was carried out to investigate the relationship between restless legs syndrome and sleep quality among hemodialysis patients.Materials and Methods: In this case-control study, 74 hemodialysis patients with sleep disorders (cases) were selected by convenience sampling method and matched with 74 hemodialysis patients without sleep disorders (control) in sex and age (±5). Then, restless legs syndrome and its severity were compared in the both groups. The data collection instruments included demographic information questionnaire, four criteria for restless leg syndrome based on the International Restless Legs Syndrome Study Group, and Pittsburgh Sleep Quality Index. Data were analyzed by SPSS 16 independent t and chi-square tests.Results: Totally, 37.8% of hemodialysis patients showed signs of restless legs syndrome. 54.1% of cases and 21.6% of control have restless legs syndrome. The restless legs syndrome incidence in case group was 4.26 fold higher in patients with than those have no sleep disorders (CI 95%=2.08-8.74, OR=4.26).Conclusion: Given to the relationship between restless legs syndrome and sleep disturbance, restless legs syndrome screening in hemodialysis patients seems necessary.

Background and Objective: Clinical nursing education, with emphasis on centrality of student educator relationship as a powerful tool in the challenging route of education, plays a major role in students’ access to successful learning and internalization of professional roles and values. This research was conducted to explain Iranian nursing students and educators’ perception of student-educator relationship in clinical nursing education.Materials and Method: In this study, 8 nursing students of Bachlor degree with internship experience and 10 clinical nursing educators in School of Nursing and Midwifery in Mashhad, Iran, were selected by purposeful sampling method. Semi-structured interview was used for data collection. Data analysis was conducted through conventional content analysis approach for reduction and nomination of data, obtain analysis code, and recognition of themes.Results: There were two major categories concerned the students and educators' perception of relationship in clinical settings, relationship necessitates (relationship outcomes, characteristics and skills) and unspoken dialogue (action, appearance and facial expression).Conclusion: Iranian nursing students and educators’ perception of relationship in clinical nursing education is different in some cases from other countries; because of such differences, awareness of this relationship concept from their points of view could be helpful in order to communicate effectively in clinical education.