Medical-Surgical Nursing Journal
Year:2014 | Volume:3 | Issue:2|Papers Count:8

Background and Objective: Taking care of cancer patients includes rehabilitation, and rehabilitation experts emphasize on the spiritual needs of these patients. Spiritual needs are influenced by culture, which should be considered while providing spiritual care in rehabilitation. Therefore, this study was conducted aiming to present a model compatible with existing realities in Iran and its nation’s culture in order to provide spiritual care in the rehabilitation of cancer patients.Materials and Method: This was a qualitative and grounded theory study performed in 2012. The main data collection method was semi-structured interviews with 28 individuals including 18 cancer patients in one of hospitals in Tehran (with their families), 6 oncology nurses, 1 physician, 2 psychologists, and 1 clergyman. During the two stages of this study, first, the participants’ experiences were explained via the ground theory. Then using the findings of the grounded theory and review of the literature, the appropriate model was designed with the three-stage method of Walker and Awant: 1. Specifying the key concepts, 2. Reviewing of the literature, and 3. Organization of concepts and expressions in a whole framework.Results: The findings showed that the core category is the need for support, based on which the grounded theory of “endeavor to achieve support” and the “support-based spiritual rehabilitation care model” were presented. The model contained two components i.e. supporting the patient directly (administering the systematic process of spiritual care) and indirectly (enabling the nurses, establishing a team for the spiritual care in the rehabilitation, developing spiritual competency in the nurses, and supporting the family).Conclusion: According to this model, recognizing and meeting the spiritual needs in patients by a systematic approach, developing of knowledge and sensitivity in the nurses regarding these needs, developing spiritual competency and enabling in the nurses, and supporting the family are necessary for providing spiritual care during rehabilitation.

Background and Objective: Premenstrual syndrome (PMS) is a common disorder. Due to the lack of understanding of the precise etiology of this syndrome, various treatments have been proposed. One method of treatment is the use of herbs. This study aimed to investigate the effect of valerian root extract on intensity of mood and behavioral symptoms of PMS.Materials and Method: In this double-blind clinical trial, 100 female students of Islamic Azad University, Tonekabon Branch, Mazandaran Province, Iran, with PMS were randomly assigned to groups receiving valerian and placebo in 2013. The participants received 2 pills daily seven days before until the beginning of their menstrual cycle for 3 cycles and recorded their symptoms. The data gathering tools included demographic information questionnaire and daily symptoms severity questionnaire. Data were compared before the intervention, and the on the first, second, and third cycles after the intervention using Student’s independent ttest, paired t-test, and repeated measures analysis of variance SPSS16. All P values <0.05 were considered significant.Results: A significant difference was observed in mean premenstrual mood (P<0.001) and behavioral (P<0.001) symptoms severity of in the intervention group before and after the intervention. However, this difference was not statistically significant in the control group. Moreover, repeated measures ANOVA showed that the difference in mean of mood and behavioral symptoms before the intervention, and one, two, and three months after the intervention in the intervention group was significant (P<0.001). Nevertheless, this difference was not significant in the control group.Conclusion: The results of this study showed that valerian root extract may reduce mood and behavioral symptoms of premenstrual syndrome.

Background and Objective: The adequacy of hemodialysis as a predictor of mortality of hemodialysis patients is widely known. In diabetic patients undergoing dialysis, blood glucose levels change and the risk of end stage renal disease (ESRD) increases. Thus, this study was conducted with the aim of determining the adequacy of hemodialysis in diabetic and nondiabetic patients who were admitted to 22-Bahman Hospital in Gonabad, Iran in 2012.Materials and Method: In this descriptive-analytical study, 33 patients from the hemodialysis unit of 22-Bahman Hospital were recruited through the census method. They were divided into two groups of diabetic (n=16) and nondiabetic patients (n=17). Blood samples were taken in 3 steps; before, during, and at the end of hemodialysis. Variables such as gender, age, type of filter, duration of each session, and frequency of dialysis in a week, were collected by a questionnaire. Desirable adequacy of hemodialysis was considered as KT/V>1.2 and urea reduction ratio (URR)>65%. Data were analyzed by SPSS19 and using chi-square, Fisher’s exact test, and repeated measures ANOVA.Results: URR index of all the diabetic patients and 41.2% of nondiabetic patients was lower than 65%. KT/V index of 64.7% of nondiabetic and 31.3% of diabetic patients was higher than 1.2. Fisher’s exact test showed that dialysis adequacy of the two groups based on the URR index had a statistically significant difference (P=0.007). However, the two groups had no significant difference in regard to duration of each session, frequency of dialysis in a week, type of filter, and pumping rate.Conclusion: According to URR index, adequacy of dialysis in diabetics was lower than nondiabetic patients. Therefore, the implementation of interventions to increase the adequacy of hemodialysis in this group of patients is necessary.

Background and Objective: Diabetes is the most common endocrine disease. In phone follow up, patients with some problems are training in special times by nurses. This study was conducted to determine the effect of follow-up by phone calls on quality of life (QoL) in Kerman, Iran.Materials and Method: This was a quasi-experimental study on 50 type II diabetic patients in census manner with two randomized control and experimental group in Kerman on 2011. For data collection, short form of QoL (SF36) questionnaire was used before and after the intervention. Chi-square, analysis of variance (ANOVA), independent t-test, and paired t-test were used in SPSS18 to analyze data.Results: Results showed a statistical significant difference between the control (51.12±7.02) and experimental group (67.59±7.45) in global quality of life scores (P=0.005). In different domains except physical function and pain in other subjects such as role limitation (P=0.001), freshness (P=0.002), psychological health (P=0.003), social performance (P=0.03), spiritual wellbeing (P=0.003), significant difference was observed (P=0.003). In demographic variables there was an association between age (P=0.04), sex (P=0.03), educational level (P=0.04) and quality of life.Conclusion: According to the results of this study, follow-up by phone calls was able to improve the quality of life in the study. Therefore, this method is recommended for patients with type II diabetes.

Background and Objective: Pregnancy is a critical period in the lives of women and is associated with their increased nutritional requirements. Adequate nutrition during this period has a significant impact on maternal and child health. The present study was conducted in order to assess the nutritional status of pregnant women of Iranshahr, Iran.Materials and Method: A cross-sectional, descriptive analytical study was carried out in Iranshahr, Iran in 2011. Using cluster sampling method, 5 health-care centers were selected. Then, 352 pregnant women referring to the selected health centers were chosen using convenience sampling. The height and weight of each subject were measured and the demographic information form and two questionnaires consisting of 24-hour dietary recalls and the Food Frequency Questionnaire (FFQ) were completed through interviews. Data were analyzed using SPSS18, Student’s t-test (comparison of means with a constant value), and non-parametric tests including Mann-Whitney (comparison of two groups) and Kruskal- Wallis (comparison of more than two groups). Moreover, the Pearson correlation coefficient was used for the comparison of different variables.Results: Food analysis revealed that, with the exception of folic acid (P<0.001), and vitamins A (P=0.001) and E (P<0.001), the average energy of protein, and other nutrients’ intake in the majority of pregnant women were in accordance with the recommended dietary allowances (RDA). Food intake patterns showed that the consumption of bread and cereals (P<0.001), dairy products, and fruits and vegetables (P=0.001), especially in low weight women, was significantly lower than the recommended levels (P<0.001). Furthermore, the consumption of sweets (P=0.001) and fats (P<0.001) in underweight women was lower and in overweight and obese pregnant women was higher than other samples.Conclusion: The inappropriate dietary pattern and lack of variety in the diet of most pregnant women resulted in the insufficient intake of some micronutrients. Thus, considering the importance of the nutritional status of pregnant women, it is recommended that nutritional education programs be undertaken simultaneously to the implementation of health services programs.

Background and Objective: A healthy diet is one of the most important matters in caring and preventing type II diabetes in susceptible individuals. In interventional trainings performed in Iran, the family members of patients with type II diabetes are very rarely entered into training programs. Therefore, the aim of this study is to investigate the effect of education based on the collaborative care model on nutritional behavior of families of patients with type II diabetes.Materials and Method: This study is a single-blind randomized clinical trial undertaken in the Educational Center of Diabetes of Tabriz, Iran, in 2012. The sample consisted of 40 first-degree family members of patients with type II diabetes (one member from each family) who were randomly divided into two groups of intervention (20 individuals) and control (20 individuals). In order to evaluate nutritional behavior, the modified lifestyle questionnaire was applied. First, the two groups took the pre-test and then collaborative training was held for seven one-hour sessions for the intervention group. Collaborative training consisted of the stages of motivation, preparation, engagement, and evaluation. The two groups took the post-test 3 months after the intervention. The data were analyzed by using chi-square and Student’s independent t-test in SPSS version 13.Results: There was no statistically significant difference between the intervention and control groups in regards to age, gender, education level, job, marital status, and economic status. After the educational intervention, the intervention group reported better performance in comparison to the control group in items related to using fast foods (P=0.001), fruits (P=0.005), vegetables (P=0.004), canned food (P=0.003), sweets (P=0.001), solid vegetable oil (P=0.007), sausages (P=0.005), the usual way of cooking food (P=0.003) and eating heavy and late-time dinners (P=0.007).Conclusion: The results showed that training based on the collaborative care model modifies the lifestyle of family members of patients with type II diabetes in most of the indices and nutritional behaviors. Based on the results, it is recommended to use the collaborative care model for nutritional training of family members of patients with type II diabetes.

Background and Objective: Pain and instability are the most common problems in patients with chronic low back pain and the main causes of disability in these individuals. Many studies have been performed on the effects of aquatic exercises on the treatment of individuals with back pain. However, the effect of stability exercises in water on pain intensity and balance indexes in subjects with nonspecific chronic low back pain (CLBP) has been less studied. Therefore, this study aimed to examine the effect of stabilization training in water on pain and balance in males with nonspecific CLBP.Materials and Method: This quasi-experimental study was performed on 24 male patients who were referred to the clinic of Ghaem Hospital, Mashhad, Iran, and were diagnosed with nonspecific CLBP in 2012. Participants were selected by purposive sampling method randomly and were divided into two groups of intervention and control. The intervention group performed stabilization exercises in water for 6 weeks (3 sessions per week) under the supervision of the researcher and the control group did not perform any exercises. The pain and balance indices [overall, anterior–posterior (AP), and medial-lateral (ML)] were measured, respectively, by the Quebec Back Pain Disability Scale and the Biodex Stability System before and immediately after exercise. For data analysis, two-way repeated measures ANOVA was applied using SPSS18 at the significant level of P≤0.05.Results: Our finding showed that mean pain intensity scores of the two interventional and control groups differed significantly (P=0.001); pain score had significantly decreased in the intervention group compared to the control group. Moreover, a significant improvement was observed in the interventional group compared to the control group in terms of the balance variable in the AP (P=0.036), ML (P=0.006), and overall (P=0.005) indices.Conclusion: The findings revealed that stabilization exercise in water reduces pain and improves balance in patients with nonspecific CLBP.

Background and Objective: Venous catheter placement is one of the most common invasive procedures performed by nurses. Prevention and relief of pain in children is of great importance. This study aimed to determine the effects of EMLA cream on pain of venipuncture in 6-12 year old hospitalized children.Materials and Method: This study was a randomized clinical trial on children admitted to hospitals of Rafsanjan University of Medical Sciences in 2013. The 80 hospitalized children were randomly divided into intervention and control groups (40 children in each group). In the intervention group, 45-60 minutes before venipuncture, EMLA creams and dressing was applied, and in the control group, routine venipuncture was performed. Pain intensity was measured in both groups using a numeric scale of pain and pain behavior scale during venipuncture and 5 minutes after venipuncture. Data were analyzed by using chi-square, fisher’s exact test, and mann-whitney test in SPSS18.Results: The results of this study showed that there was a statistically significant difference in the intensity of pain during venipuncture between the two groups (P<0.001).The mean pain intensity based on the numerical scale (intervention group: 3.45±1.69; control group: 8.65 ± 1.5) and behavioral scale (intervention group: 2.75±1.4; control group: 7.75±1.6) was lower in the intervention group than the control group.Conclusion: The use of EMLA cream reduces the pain of venipuncture in children to a tolerable level.