فهرست مطالب

پرستاری مراقبت ویژه - سال دهم شماره 1 (پیاپی 33، Feb 2017)

نشریه پرستاری مراقبت ویژه
سال دهم شماره 1 (پیاپی 33، Feb 2017)

  • تاریخ انتشار: 1395/11/14
  • تعداد عناوین: 7
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  • Ghasem Abotalebidariasari, Robabe Memarian *, Zohreh Vanaki, Anoshirvan Kazemnejad, Nasim Naderi Page 1
    Background
    Self-care is a self-regulatory action, which necessitates self-care power.
    Objectives
    The current study aims at exploring self-care agency power components among patients with heart failure by the Orem self-care theory.
    Methods
    The current qualitative study utilized content analysis approach based on the Orem self-care theory. Twenty-seven patients with heart failure and their family members were purposefully recruited from Shahid Rajaie cardiovascular center, Tehran, Iran. The study data were collected from December 2014 to May 2015 through in-depth semi-structured interviews. Data collection was continued until data saturation which was attained after the 24th interviews and hence, the last 3 interviews produced no new data. Data analysis was carried out by the directed content analysis approach proposed in 2005 by Hsieh and Shannon.
    Results
    Data analysis yielded 79 primary codes, which represented the instances of self-care agency power components among patients with heart failure. The main components of self-care agency power were ability to acquire self-care knowledge, ability to identify factors aggravating heart failure, motivation for self-care, physical ability to engage in self-care activities, ability to adjust physical activities in order to save energy, ability to monitor bodily functions, reasoning about the causes of related symptoms, ability to decide on appropriate self-care measures, ability to understand the nature of the disease, ability to communicate with others to use their capabilities for self-care, ability to organize self-care measures, and ability to adhere to self-care activities. The most basic abilities are self-care knowledge, physical ability, and self-care motivation.
    Conclusions
    The findings of the study indicated that effective self-care among patients with heart failure requires a wide range of self-care abilities. Nurses can use the findings to develop self-care plans for patients with heart failure.
    Keywords: Self, Care Agency Power Components, Heart Failure Orem Self, Care Theory
  • Hosein Mahmoudi, Eesa Mohmmadi, Abbas Ebadi Page 2
    Background
    An emergency department (ED) has multiple patients with a wide variety of conditions that receive care simultaneously.
    Objectives
    This study aimed at exploring the meaning of emergency care at a hospital emergency department.
    Methods
    A qualitative research design with content analysis method and purposeful sampling was used to identify the meaning of care. In-depth interviews were conducted with 17 Iranian emergency department nurses from 2 military hospital emergency departments in Tehran, during year 2015.
    Results
    Three main categories emerged from the data. These categories included (1) accuracy, (2) speed, and (3) comprehensive action and caring attention. These 3 main categories represented the contextual meaning of emergency nursing care.
    Conclusions
    It was determined that the meaning of care in the studied context was different from other contexts, thus nurse managers must pay more attention to this diversity.
    Keywords: Content Analysis, Meaning of Caring, Emergency Room Nursing, Qualitative Study, Iran
  • Hamid Naderloo, Zohre Vafadar, Alireza Eslaminejad, Abbas Ebadi Page 3
    Background
    Low life expectancy is one of the common problems among patients with chronic obstructive pulmonary disease (COPD).
    Objectives
    Thus, the present study aimed at evaluating the effect of motivational interviewing (MI) on the life expectancy of these patients.
    Methods
    After repeatedly subjecting 54 patients to several evaluation techniques in a two-group clinical trial, both MI and lifestyle training were conducted for the 27 individuals in the experimental group receiving the intervention, while only lifestyle training was provided for the 27 individuals in the comparison group. The adult hope scale (AHS) questionnaire was checked 1 and 2 months later.
    Results
    Life expectancy was meaningless in both groups before the intervention. However, according to the evaluations during the 1 month and 2 months follow up, the average point of life expectancy increased in the intervention group (P = 0.002 and P = 0.008, respectively).
    Conclusions
    Performing the MI approach could increase life expectancy in patients with COPD.
    Keywords: Life Expectancy, Motivational Interviewing, Chronic Obstructive Pulmonary Disease
  • Behnam Esbakiyan Bandpey, Majideh Heravi-Karimooi, Nahid Rejeh, Hamid Sharif Nia Page 4
    Background
    Because of its nature, nursing is one of the stressful jobs. Abundant stressful factors existing in this job cause the occurrence of physical and mental disorders in nurses.
    Objectives
    Therefore, the aim of this research was to determine the effect of health messages on job stress of nurses working in ICU (intensive care unit).
    Methods
    This empirical study was performed in ICUs of hospitals in Babol city in 2015 - 2016. The research population included all employed and eligible nurses working in ICUs of hospitals affiliated to Babol University of Medical sciences. After homogenization, the subjects were randomly divided into two groups of 40 named intervention and control groups. The tools for data collection included a demographic form and OSIPOW job stress questionnaire, which were completed by both groups. Then, for the nurses in the intervention group, 2 messages per week were sent regularly with a constant interval for three months. The OSIPOW questionnaire was completed by both groups one day and one month after the completion of the intervention. Statistical analysis was performed using SPSS v 20 software. Shapiro Wilk test was used to examine normal distribution of continuous quantitative variables. The data were evaluated using descriptive and inferential statistics (Mann Whitney and Freedman tests). Significance level was set at P
    Results
    The nurses participating in this study were homogenously distributed in two groups in terms of job stress levels before performing the intervention. The mean scores of job stress in nurses working in ICU were 242.05 ± 22.72 in the intervention group and 241.80 ± 24.22 in the control group (P = 0.068). Also, the mean scores of job stress in nurses in the control group before the intervention, one day, and one month after the completion of the intervention were not significantly different from each other (P
    Conclusions
    The findings of this research showed that job stress level in nurses of the case group reduced after the intervention. Therefore, sending health messages can cause a decrease in job stress among nurses working in intensive care units.
    Keywords: Health Messages, Job Stress, Nurses, Intensive Care Unit (ICU)
  • Aliakbar Keykha, Hasan Askari, Ali Navidian, Bibi Mahdie Khodadadi Hosseini Page 5
    Background
    Determining the level of consciousness is one of the main responsibilities of nurses in intensive care unit (ICUs). Scales used to determine the level of consciousness should be less affected by the injection of analgesics and sedatives and should provide proper vision of the patient’s status.
    Objectives
    This study was conducted to assess the ability of two tools including Glasgow coma scale (GCS) and full outline of unresponsiveness (FOUR) score in measuring the level of consciousness and outcome in patients receiving sedation under mechanical ventilation.
    Methods
    The present analytical descriptive study was conducted on 80 trauma patients receiving sedation under mechanical ventilation in 2016 in Zahedan, Iran. The patients having inclusion criteria were evaluated using the two tolls of GCS and FOUR score on admission and after starting and stopping sedation until the last days of hospitalization. The data were analyzed to assess the ability of the tools in measuring the level of consciousness after starting sedation and determine the outcome using independent t-test, chi-square test, and repeated measures ANOVA.
    Results
    Of 80 patients studied, 61 were male (76.2 %) and the rest were female. Independent t-test results showed no significant association between the mean admission GCS score and mortality though the deceased patients obtained higher mean score (P = 0.978). Independent t-test revealed no significant association between the mean FOUR score on the first-day and mortality, though the deceased patients gained higher mean score (P = 0.578). The results of repeated measures ANOVA indicated that the mean GCS score after onset of sedative infusions reduced significantly compared to earlier (P = 0.001). This test also revealed that the mean FOUR score after onset of sedation decreased slightly than before although this reduction was not statistically significant (P = 0.432).
    Conclusions
    According to fewer changes in FOUR score than the GCS score after starting and stopping sedation, it is more appropriate criterion for measuring the level of consciousness in trauma patients receiving sedation.
    Keywords: Glasgow Coma Scale, FOUR Score, Sedative Infusions, Trauma Patients
  • Fariba Nasiri Ziba, Fahime Barghi Shirazi Page 6
    Background
    Awareness of healthcare providers (especially nurses) about common medical problems is an important issue in realizing the significant effects of pain physiology. Pain management in myocardial infarction is a major responsibility of nurses, which can be accomplished through care provision for patients. Nurses’ age, type of employment, and other factors such as work experience have great impacts on the efficacy of pain management and the related parameters.
    Objectives
    To determine the level of nurses’ awareness about pain management in myocardial infarction as a critical care issue, based on the clinical data.
    Methods
    This descriptive cross sectional study was carried out in teaching hospitals, affiliated to Shahid Beheshti University of Medical Sciences. In this study, 200 nurses were selected as the participants. The data collection tool was a questionnaire consisting of 2 parts. The demographic and awareness sections of the questionnaire consisted of 10 modules of the Faculty of Medicine. The selection criterion was defined to identify the validity and reliability of actual care implementation. Each nurse was evaluated in the morning, afternoon, and evening shifts in a live response manner to determine the level of care provision. It took 20 minutes to complete the questionnaire. Dishonesty in responding to the questionnaire (predefined) was controlled and eliminated. For data analysis, statistical tests including independent t test were performed, using SPSS version 21.
    Results
    Based on the findings, the nurses’ knowledge (skills and expertise) about myocardial infarction pain management had a significant relationship with their consciousness, type of employment (P = 0.022), and sex (P = 0.024).
    Conclusions
    The results showed that sex and type of employment play effective roles in myocardial infarction pain management.
    Keywords: Knowledge, Nurses, Pain Management, Myocardial Infarction, Awareness
  • Claudio Tacconi, Andrea Schiavon Page 7
    Objectives
    This study is to propose recommendations regarding glycemic control in intensive care in the post surgical patient.
    Methods
    It was carried out as a literature review using the following search terms: post anesthesia nursing, hypoglycemia, hyperglycemia, intensive care units, glycemic control.
    Results
    Within each article, outcomes of patients undergoing continuous treatment with insulin infusion were examined in addition to the percentage of patients who fell in hypoglycemia or hyperglycemia.
    Conclusions
    Given the risks of hypoglycaemia, the authors recommend: Start early infusion at a constant supply of glucose; the start of continuous infusion of insulin to the overrun of 180 mg/dL; the use of solutions for infusion at a concentration of 1 unit mL, and glucose monitoring every 2 hours
    Keywords: Post Anesthesia Nursing, Hypoglycemia, Hyperglycemia, Intensive Care Units, Glycemic Control