MILITARY CARING SCIENCES
Year:2017 | Volume:4 | Issue:1 (11) |Papers Count:8

Introduction: Sleep disorder is one of the common problems in veterans with post-traumatic stress disorder symptoms over time.Objective: This study aimed at evaluating sleep quality in women victims of post-traumatic stress disorder.Materials and Methods: This qualitative study was carried out on 11 wives of war veterans with post-traumatic stress, during year 2015. A purposive sampling method and data collection using semi-structured interviews was used. After data collection and coding, content analysis (conventional content analysis) was performed. The consequences of sleep disorders were categorized in three groups: fear of going to sleep, nightmares, sleep interrupted and classified. Outcome of fear of sleep included (restlessness, insomnia, husband, wife scary behavior during sleep, fear of sleep, and onset of sleep), nightmares (remembering and bad replay of memories during sleep and jumping during sleep), interrupted sleep, and style (fear stress, anxiety sleep, and awakening frequently during sleep).Discussion and Conclusion: Most of the pressure and stress of everyday life had significantly impaired sleep quality of veterans’ wives. Psychological and social support to improve the inspection requirements of quality of life could improve sleep hygiene and mental health of the victims’ wives.

Introduction: A large number of people are affected by wars and nuclear-radiological crises. These crises due to human and transport resources and absence of a single clinical guide triage and prioritize victims can resulting in many causulties. For this purpose, local clinical guides could help reduce mortality.Objective: This study aimed at developing triage clinical guidelines in nuclear_ radiological events that are all things considered.Material and Methods: This study had a qualitative and combined two-step design. The first step was an overview study and a systematic review done on articles, books, organizational documents, and pre-hospital triage guidelines in nuclear-radiological events. In the second step of this study, the Delphi method was used to deal the agreement among experts. This means the full resources of the international clinical guidelines in nuclear-radiological events using library studies and internet search in databases (Pub Med, Google Scholar, Science Direct) between years 2000 and 2017 were selected; related resources were extracted and quality survey based on the AGREE II (Appraisal of Guidelines for Research and Evaluation II) scoring system was done and the initial guideline was drafted. The Delphi method, in order to summarize information in two rounds, was used with 6 professors and experts. Finally, data was summarized and final guidelines were developed.Results: After selecting resources using the AGREE II instrument, the initial draft guidelines were written by the research team and were in hands of professionals for validation in the form of the Delphi method in two stages. After 6 weeks of the first stage, comments were collected and content integrated and changes were made. Subsequently, the draft was sent for the second round of Delphi. After collecting the opinions, consensus was reached on the comments and findings of published pre-hospital triage guidelines in nuclear-radiological events.Discussion and Conclusion: A more organized management of injuries and their prioritization in order to provide the best treatment at the right time was done with regards to nuclear- radiological contamination.

Introduction: Peripheral intravenous catheterization is the most common invasive therapy for hospitalized patients to administer fluids, drugs, and blood products. Phlebitis is one of the serious complications that could influence the patient›s health status.Objective: This study aimed at investigating the effect of 2% chlorhexidine gluconate solution on prevention of phlebitis related to peripheral venous catheter in patients hospitalized in cardiac care units.Material and Methods: This double-blind randomized clinical trial study was conducted on 40 patients admitted to cardiac care units of Beasat Military Hospital, Tehran, Iran during years 2016 and 2017. Patients were recruited by the convenience sampling method and randomly allocated to 2 intervention and control groups. The Jackson Phlebitis Scale (Visual Infusion Phlebitis Scale) was used to assess phlebitis. The 2% chlorhexidine gluconate solution was used daily around the peripheral venous catheter in the intervention group for 3 days. Degree of phlebitis was recorded at the same time and IV dressing was changed. In the control group, degree of phlebitis was recorded and IV dressing was changed in 3 days.Results: The Mann-Whitney U and chi-square tes showed no significant differences between the 2 groups regarding intensity (degree) and incidence of phlebitis at 24, 48, and 72 hours after the intervention (P>0.05). Friedman test showed that average of phlebitis in both groups increased during the 1st, 2nd, and 3rd day (P>0.05).Discussion and Conclusion: It seems that the IV dress changing is effective and daily use of the 2% chlorhexidine gluconate solution is not recommended. Future studies with a large sample size is recommended.

Introduction: Angiography is a detailed and useful method in the diagnosis and treatment of coronary artery disease. One of the steps of angiography is taking out of sheath. This aggressive procedure causes anxiety in many patients. Therefore, hemodynamic indexes (heart rate, blood pressure and respiratory rate) may change.Objective: This study aimed to evaluate the effects of inhaling lavender essential oil on hemodynamic indexes during taking out a sheath in patients after coronary angiography.Materials and Methods: This was a quasi-experimental study. Seventy patients undergoing angiography referred to a military hospital in Tehran, Iran were recruited with convenience sampling method during 2015-2016. Then, patients were randomly assigned into intervention and control groups. The intervention group inhaled lavender essential oil during sheath take out and in the control group the placebo of lavender extract inhalation was used. Hemodynamic indexes of patients were measured before, during, 10 minutes and 20 minutes after the aromatherapy. Data were analyzed using chi-squared test, Fisher›s exact test and ANOVA with SPSS software (version 21).Results: After the intervention, there was a statistical difference in means of respiratory rate (P<0.05) and diastolic blood pressure (P<0.05) of the two groups. The ANOVA test showed that mean of systolic blood pressure (P=0.001), diastolic blood pressure (P=0.001), heart rate (P=0.001), and respiratory rate (P=0.001) in the intervention group decreased during time.Discussion and Conclusion: The use of inhaled lavender extract during sheath take out in patients after coronary angiography can reduce hemodynamic indexes. Further studies with high sample size is recommended.

Introduction: Coronary heart disease is a chronic disease that requires long-term treatment, care and monitoring to prevent disease progression and its complications. The financial and social burdens of the disease in the society are too high to have made researchers look for effective solutions for reducing the side effects in order for patients to have qualitative lives. The aim of this study was to evaluate the effects of care model implementation so as to reduce the complications and improve the quality of life for these patients.Materials and Methods: This study was a randomized clinical trial. The study population included 58 patients with coronary artery disease who were hospitalized in intensive care units of NAJA Vali-Asr and 502 AJA hospitals during February to June 2016. These patients were divided into intervention and control groups according to the inclusion criteria and the specific block method. Then, collaborative care model in the test group was administered for three months and Nottingham quality of life questionnaire was used to collect information. The data were analyzed with SPSS 22 software and independent t-test, t-test and Fisher›s exact test.Results: Statistical analysis between the experimental and control groups showed no significant difference in demographic characteristics. Quality of life mean scores before the intervention were 141.59 ± 137.23 and 209.12 ± 144.52 in the experimental and control groups, respectively. Independent t-test showed no significant difference in quality of life between the two groups before the intervention (P=0.073). However, the quality of life scores decreased in experimental and control groups (76.11 ± 80.97 and 167.78 ± 151.98 respectively), indicating a significant difference after three months of intervention (P<0.05). Comparing the mean scores of four times of observation showed a significantly decreasing trend (P<0.05) in both groups after the intervention. The significant difference in the level of effectiveness was average.Discussion and Conclusion: Care models have important roles in enhancing the quality of care for patients, especially in chronic diseases. Collaborative care model is effective for the care of heart disease, and training of this model is recommended for critical care nurses.

Introduction: Investment of the US army on virtual technology in 1999 has caused this technology to become one of the major technologies in the health field. One of the important fields of applied technology is assisting patients, who cope with longlasting, painful, and stressfultroma, such as cancer. Presence of pain, depression, tension, and stress in these illnesses has caused researchers to perform extensive research in this field.Objectives: The main purpose of this research was to determine the effect of virtual reality on mental disorders, such as anxiety, depression, and stress in people affected by cancer.Materials and Methods: The method of the research was quasi-experimental with pretest-posttest design with a control group. The sample included all cancer cases over 12 years old, who attended Tehran research hospitals, and treatment and teaching cancer institutes, during years 2014 and 2015. The present research was a semi-experimental study with a pretest and posttest and a control group. Among the sample, 20 were cancer cases with psychological symptoms sampled with random sampling. The sample was divided to the experimental and control group. Then the experimental group played XBOX at least 15 minutes twice a week during one and a half months. At the end of this period, these 2 groups were examined through interviews and the DASS questionnaire.Results: The result of covariance analysis indicated that using this modern technical device had a meaningful effect on reducing psychological symptoms in cancer patients.Discussion and Conclusion: Since treatment intervention and clinical practices take place out of routine and real life of patients, such as at the hospital and care centers, in this method the therapist can do his task in a controlled virtual situation so that practices and treatment techniques are applied in a credential and proper situation with individual characteristics.

Introduction: Training of patients with diabetes and heart disease is a major problem in achieving optimal adherence to the treatment regimen. One of the most influential factors is selecting an appropriate teaching method. On the other hand, focusing on proper education for the patients› family could facilitate the desired management and better control of the disease.Objective: The aim of this study was to investigate the effect of the family-centered empowerment model on treatment adherence in patients with type II diabetes and heart problems.Materials and Methods: This study was a clinical trial, in which 62 patients with type II diabetes and heart disorders were selected from AJA hospitals, during year 2015. In order to collect data, a demographic questionnaire, treatment adherence in chronic diseases questionnaire, and empowerment questionnaire, with parameters HBA1C and LDL were used. All questionnaires were handed over and filled in by 2 groups, before and after the intervention; the treatment adherence in chronic diseases questionnaire was handed over and filled in 4 weeks after the intervention. The data was analyzed using the SPSS version 21 software and chi-square test, Fisher›s exact test, independent sample t test, paired sample t test, and repeated measures analysis (ANOVA).Results: No significant differences was found in demographic factors between the two groups before the intervention (P>0.05). There was no statistically significant difference in the mean scores of empowerment of patients and family members, knowledge, treatment adherence in chronic diseases, and the mean value of HBA1C and LDL before the intervention (P>0.05), yet after the interventions, a statistically significant difference was observed between the variables (P<0.05), except the variable LDL, for which the difference was not statistically significant (P>0.09). The coefficient of variation showed that the reduction of LDL was greater in the intervention group than the control group.Discussion and Conclusion: The findings showed the positive effects of the implementation of family-centered empowerment model to increase treatment adherence in the patients. Given the important role of the family in the management and control of chronic diseases, including type 2 diabetes and it’s complications, especially heart disease, using this template to achieve biologically optimal adherence is recommended.

Introduction: Regarding the advantages of breastfeeding in terms of nutritional values and immunity, saving 5.1 million children annually, it seems that related factors should be recognized in this field and mothers must be encouraged to use their own milk to feed infants.Objectives: This study aimed to evaluate and compare the quality of breastfeeding in postpartum mother’s undergone cesarean and vaginal delivery.Materials and Methods: In this causal-comparative study, 113 mothers and newborn infants by cesarean section and normal delivery in 2015 in Military Family Hospitals, Najmieh, Besat, Chamran and Hagar in Tehran were compared. The quality of breastfeeding was evaluated using infant breastfeeding evaluation checklist.Results: Breastfeeding quality of women›s means and standard deviations in normal vaginal delivery and cesarean were 110.66 ± 12.36 and 114.35 ± 5.89, respectively (P=0.045).Discussion and Conclusions: The study showed that mothers who deliver vaginally compared to caesarean have a better quality of breastfeeding. Mothers who had natural delivery were more successful at breastfeeding and higher quality of life.