Medical-Surgical Nursing Journal
Year:2016 | Volume:5 | Issue:1|Papers Count:8

Background and Objective: Many of the nurses has been calling for the integration the complementary therapies into the conventional medicine. Some of them use these methods in their clinical practice. The reasons for application of complementary therapies by nurses are different in various fields. Identification of these reasons are essential and important. So, this study was conducted to explore the nurses’ perceptions of the reasons for using complementary therapies in clinical nursing practice.Materials and Method: This qualitative content analysis study was done from June 2014 to July 2015 in Isfahan and Kashan cities. Sampling was done purposively and was continued until data saturation. Semi-structured interviews were done with fifteen nurses who had first-hand and rich experience. Data were analyzed concurrently with data collection. Data analysis was done via the conventional content analysis approach and MaxQDA software was used to help organizing and analyzing the data.Results: Results showed that 4 major categories including ethical trends & perceptions, ‘commitment beliefs, attention to information from informal sources' and attention to information from formal sources. Also two main themes including‘nurse's moral obligation' and ‘nurse’ use of information sources' were abstracted.Conclusion: The nurse's practice about the reasons for using complementary therapies in clinical settings can be explained by their moral obligation and obtained information from various sources especially informal sources. These findings are useful for managers to designing guidelines and models related to integration of complementary therapies into nursing practice.

Background and Objective: Hospitalized patients in the Coronary Care Unit require the frequent blood sampling for diagnostic and treatment assessment. According to routine plan of unit, a new venipuncture was performed to obtain each blood sample. This causes damage and pain in patients. The current study was conducted to compare the effect of blood sampling by direct venipuncture with venous catheter on the blood biochemical results in patients hospitalized in CCU.Materials and Method: In this quasi- experimental study, 80 hospitalized patients were selected through purposive sampling in CCU in one of the teaching hospitals in Zahedan in 2015. At first in order to doing the biochemical tests, 5 cc blood sample was obtained from IV catheter and the same volume was obtained by direct venipuncture from another hand. Blood sample were assessed in terms of glucose, cholesterol, triglyceride, sodium, potassium, urea, creatinine and CRP. Data were analyzed using paired T- test and Pearson correlation coefficient test in SPSS 16.0.Results: The laboratory values of glucose, cholesterol, triglyceride, sodium, Potassium and CRP were not significant different between the two blood samples by venipuncture and venous catheter. But there was significant difference between the BUN level (p=0.004) and Creatinine in two methods (p = 0.015).Conclusion: According to the results, the venous catheter can be used for obtaining the blood sample and laboratory assessment. But, due to significant difference in level of BUN and creatinine test results, further studies are needed.

Background and Objective: The successful glycemic control in diabetic patients is very important. Since the poor self-care is reported as the most important causes of mortality and complications, therefore these patients require self-care knowledge. This study aimed to determine the effect of education of self-care behaviors on HbA1C level in diabetic patients.Materials and Method: In this clinical trial, 80 diabetic patients referred to the diabetes clinic in Bandar Abbas were selected through random sampling and then were randomly allocated into two groups of intervention and control based on stratified random sampling. Designed educational program was implemented in 9 sessions (60 minutes, once a week for 12 weeks) for patients in the intervention group. Patients in the control group were received usual care of clinic. Data were collected through using demographic information form and HbA1c test. Data were collected at the beginning of the study and 12 weeks after the intervention. Data were analyzed by SPSS software (version 18) using independent T- test, paired T-test, Mann-Whitney U and chi-square.Results: Before the intervention, the HbA1c average in the intervention and control groups was 8.18±1.66 and 8.41±2.10, respectively and after the intervention these values were changed to 7.78±1.48 and 8.82±2.11 in the intervention and control groups respectively (p=0.01).Conclusion: Implementation of educational program of self-care behaviors was effective in reducing HbA1C and it can be used as an appropriate educational method by nurses and other health care team in controlling of diabetes in patients.

Background and Objective: Patients experience severs pain after cardiac surgery due to incision of anatomical components of the chest wall. Given that the cryotherapy is one of the simplest and cheapest non-pharmacological methods of pain relief, the current study was conducted to determine the effect of cryotherapy on the severity of thoracic pain in patients undergoing coronary artery bypass grafting surgery.Materials and Method: This clinical trial study was conducted on 50 patients undergoing coronary artery bypass grafting surgery in one of the educational hospitals in Zahedan in 2015. Patients were selected conveniently and then were randomly allocated into two intervention and control groups (each group containing 25 patients). At first, pain of patients was measured in two groups after three cycles of deep breathing and coughing by using visual analogue scale. In intervention group, ice pack was used on the chest wound dressing of patients for 20 minutes alternatively at 5 minutes intervals in intervention group. Then, both groups received emotional support for 15 minutes and the pain score was measured again. Data were analyzed using Chi-square, independent t-test, Paired t-test, and analysis of covariance tests in SPSS 21.Results: The mean pain score before the intervention in the intervention and control groups were 60.16±13.45 and 58.64±14.42, respectively. These values were changed after cryotherapy to 45.16±15.25 in the intervention group and 58.60±14.40 in the intervention group (P<0.001).Conclusion: The use of cryotherapy can reduce severity of Thoracic Pain related to coughing and deep breathing in patients undergoing coronary artery bypass grafting surgery. Therefore, this method can be used as a non-pharmacological method of pain relief.

Background and Objective: Irritable bowel syndrome is one of the most common functional gastrointestinal disorders that affect both genders in different ages, but its prevalence is higher in women. Because of perceived stress are very important factors in development of symptoms, the current study aimed to determine the effectiveness of group mindfulness based stress reduction consultation on severity of physical symptoms in women with irritable bowel syndrome.Materials and Method: This semi-experimental study was conducted on 30 women with irritable bowel syndrome referred to one of the educational hospitals in Zahedan in 2015. 30 patients were selected conveniently and then were randomly allocated into two intervention and control groups. The intervention group was received the 8 sessions (each session 90-minutes) educational program. Data were collected through the IBS Symptom Severity Scale before and one week after the intervention. Data analysis was done through using SPSS 20, chi-square, independent T-test, paired T-test and ANCOVA.Results: The mean of physical symptoms severity before the intervention in intervention and control groups was 309.46±32.19 and 304.01±34.01 respectively that after the intervention were changed to 228.60±13.56 in intervention (p=0.001) and 299.80±15.72 in control group (p=0.8) The result of ANCOVA test showed that there was significant differences between the two groups after the intervention (p=0.001).Conclusion: Group mindfulness based stress reduction method can be used to reduce severity of physical symptoms in women with irritable bowel syndrome. The application of this method in order to improve the symptoms of stress in other diseases is recommended.

Background and Objective: Chest patient is the most common symptom in coronary artery disease, but its diagnosis is a complex issue and high mortality is attributed to this symptom. Therefore, the timely diagnosis and treatment is essential. The present study was conducted to determine the effect of implementation of cardiac triage scale on time indices in patients with chest pain.Materials and Method: In this clinical trial study with control group, study population was the patients referred to emergency ward of Farabi hospital in Mashhad in 2014. 60 patients were selected purposefully and then were randomly allocated into intervention and control group. The patients in intervention group were triaged through using cardiac triage scale by researcher and in control group through emergency severity index and by nurse. Data analysis was done through using descriptive statistics, Chi-square and Mann Whitney in SPSS 21.Results: The beginning of 6- hours hospitalization (p<0.001), the time of the first visit by specialist (p<0.00) and the time of the first electrocardiogram (p<0.001) in intervention group was shorter than the control group.Conclusion: The results of the study showed that the special triage of cardiac patients can decrease the time of assessment and caring of them. Thus, the using of this method is recommended for early care of cardiac patients.

Background and Objective: Sleep disorder is considered as one of the major challenges in the Intensive Care Unit. Psychological and physical factors of environment are involved in its development. The adjustment of these factors to meet this need is essential. The current study was conducted to determine the effect of implementation of Quiet Time Protocol on sleep quality of patients in intensive care unit.|Materials and Method: In this clinical trial study, study population was the hospitalized patients in surgical intensive care unit of Ghaem Hospital of Mashhad in 2013. 60 patients were selected by convenience sampling and then were non-randomly assigned in to intervention and control groups. The quiet time protocol was implemented in intervention group for 3 consecutive nights from 7 pm to 5 am. The data were gathered through made-researcher questionnaire about sleep quality in the first, second and third nights. Data analysis was done through Fisher's exact test, chi-square, independent T-test, repeated measures ANOVA in SPSS 21.Results: The mean score of sleep quality in effectiveness aspect in intervention group was higher than the control group in all three nights (p<0.001). This mean in sleep disorders aspect after the intervention in intervention group was significantly reduced in the first (p=0.002) the second and third nights (p<0.001) in compare with control group.Conclusion: According to the results, implementation of quiet time protocol is effective on improving the sleep quality of patients in surgical Intensive Care Unit. Nurses can use this protocol to improve the quality of sleep in patients.

Background and Objective: Physical characteristics of the workplace are among the factors affecting nurses’ job satisfaction. Nurses are employed in crowded environments. The purpose of this study was to examine the effect of implementing 5S workplace organization technique on nurses’ job satisfaction.Materials and Method: In this semi-experimental study, 70 nurses from medical and surgical wards of two therapeutic-education centers in Gorgan in 2015 were studied. Nurses were selected through census and then were assigned into intervention and control groups (each group 35 persons). The intervention group took advantage from organized working environment for 6 weeks. Visual workplace audit checklist was used in order to assess the need for organizing the workplace before and one month after the intervention. Nurses’ job satisfaction was measured through the questionnaire by Kohli and Jaworski before and after the intervention in both groups. Data were analyzed by Fisher's exact test, chi-square test, independent t-test and paired t-test in SPSS 20.Results: The mean score of job satisfaction of nurses was changed after the intervention from 14.94±2.66 to 18.48±2.03 in intervention group (p<0.001) and from 15.31±1.54 to 14.80±1.47 in control group. This difference was significant between the groups after the intervention (p<0.001).Conclusion: Results showed that the implementing of workplace organization technique could improve nurses’ Job satisfaction. According to simplicity of this technique, nursing managers can use it as an effective way to improve nurses’ job satisfaction.