Journal of Multidisciplinary Care
Volume:7 Issue: 3, 2018

Patients undergoing hemodialysis report the pain of repeated insertion of vascular needles as the most stressful condition in the treatment process and the greatest concern in their lives. This pain can cause hemodynamic changes before the hemodialysis process. This study was conducted to determine the numbness effect of EMLA cream on hemodynamic changes during fistula cannulation in patients under dialysis. This study is a clinical trial conducted on 50 patients undergoing dialysis in Khorramabad Shohada Hospital in 2013. The patients were randomly divided into two groups (spelling) and (placebo) after entering the study. Hemodynamic changes were measured in two groups before and after fistula cannulation. In order to analyze the data, SPSS version 19 was used. There was no significant difference between two groups in terms of demographic variables and duration of using fistula (P>0.05). The hemodynamic parameters (systolic, diastolic blood pressure and pulse rates) were not significantly different between groups before cannulation (P>0.05). The systolic blood pressure and pulse rate in the placebo group were significantly higher than the EMLA group after fistula cannulation (P<0.001). Application of EMLA cream as an easy method reduces pain during fistula cannulation in patients under hemodialysis and provides hemodynamic stability at the onset of hemodialysis.

Cancer is one of the prevalent diseases that allocates a large part of the resources of the health care system. Stress, anxiety, and depression are major problems in patients with cancer. Therefore, the present study was conducted to investigate the effectiveness of music therapy on stress, anxiety, and depression in patients with cancer. This research was a quasi-experimental study with pre-test and post-test and control group. The statistical population consisted of all patients with cancer admitted for treatment in Valiasr Hospital in Birjand City, Iran, in 2017. Out of them, 40 people (20 men and 20 women) were selected by sampling method and randomly divided into experimental and control groups (each group included 20 patients; 10 women and 10 men). Initially, both groups were pre-tested. Then, the experimental group received music therapy (for 6 days, half an hour per day). At the end of the study, both groups responded to the research instrument (post-test). The study instrument was DOS Stress and stress questionnaire (21 questions). The obtained data were analyzed by analysis of covariance in SPSS V.22. The results showed that music therapy is effective on lowering stress, anxiety and depression in patients with cancer. Non-medical methods such as music therapy should be considered in the medical staff training program and also be considered as part of the treatment in all hospital patients, especially in special departments.

 Pregnancy is a situational crisis and in poor-managed cases, the resulting stress is great for the mother and her relatives. This study aimed to examine the effects of pregnancy classes on pregnant women.  This was a descriptive-correlational research. In this study, 80 pregnant women were selected from Semnan clinics, Semnan, Iran and entered the study. At first, their anxiety was assessed with the questionnaire and then they were participated in pregnancy classes. These classes were held for 8 sessions of 1.5 hours each. After the end of the eighth session, the participants completed the questionnaire again. The study questionnaire consisted of three sections: demographic characteristics, the Spielberger anxiety inventory, and the type of delivery selection. The data were analyzed by paired t test and Chi-square test in SPSS.  The Paired t test showed significant decrease in anxiety Mean±SD score in pregnant women from 86.7±5.17 before the study to 72.5±7.54 after the intervention (P˂0.001). The Chi-square test revealed that before the study, 68.4% of the pregnant women chose a normal vaginal delivery, but after completing the study, this rate reached 82.3% that was a significant decrease (P˂0.001).  Pregnancy classes can reduce the anxiety and increase the choice of normal vaginal delivery in pregnant women. Considering the effectiveness of pregnancy classes, especially with regard to its resulting positive mental concepts, special attention should be paid to hold these classes for pregnant women.

Human beings are not born with critical thinking, and do not acquire this ability to naturally meet their demands to survive. Even, many people never try to learn it. However, critical thinking is easily taught by qualified educators. The aim of this study was to investigate the effect of nursing process on the quality of nursing care and critical thinking of students. This quasi-experimental study was performed on 40 nursing students who were randomly divided into two groups of intervention and control groups (20 in each group). The research instrument was demographic information, quality of nursing care and critical thinking questionnaire. The nursing process workshop was held for two days for the experimental group. The critical thinking score of students and the quality of nursing care before and after the intervention were assessed in two groups. There was no significant difference between the mean score of critical thinking and the quality of nursing care in the intervention and control groups before the intervention. The results showed a statistically significant difference in the Mean±SD score of critical thinking between the intervention group (39.99±3.35) and control (24.19±2.3) groups and the quality of care Mean±SD score in the intervention group (37.56±3.4) and control (83.25±2.2) after the intervention. The mean score of critical thinking and nursing care quality in the intervention group after the implementation of the workshop increased significantly. Since the workshop was able to increase the critical thinking and quality of nursing care, the change in the educational process and use of critical thinking in the nursing process, enables nursing students to carry out nursing care with better quality.

Drug error is one of the unforgivable human errors. Challenges such as lack of national statistics and refuse of drug errors report are more important and its recognition is a must. The aim of this study was to evaluate nurses, pharmacologists, and doctors’ attitude toward medication errors, including factors that may contribute to errors, barriers to reporting them, and possible preventive measures. In this descriptive analytic study in December 2017, a survey was conducted of 91 Nurses, pharmacologists, doctors working on medical wards at an educational hospital in Chaharmahal and Bakhtiari Province in Iran. The study data were collected by a self-report questionnaire. The obtained data were analyzed in SPSS V. 16. The commonest identified causes of medication errors were doctors’ illegible handwriting, nurses’ tiredness, and distraction or interruption while administering the prescribed drugs. According to the study participants, the most important reasons for not reporting errors were the administration system and fear of being blamed. The introduction of hospital policies and implementing structured protocols on drug administration may decrease medication errors. It is also helpful to start preventive strategies such as holding regular education sessions in pharmacology and numeracy.

Permanent pacemaker implantation is one of the significant procedures for controlling and treating arrhythmias and cardiac conductive diseases. However, this method may create many physical and psychological complications for the patients and affect their quality of life. Learning self-care behaviors based on family-centered empowerment model is one of the effective methods for improving the quality of life. This study aimed to assess the effect of family-centered care on the quality of life of the patients with pacemaker implants. This study was a clinical trial conducted on 70 patients with pacemaker in Chamran Hospital in Isfahan City, Iran. The study data were collected using the SF-36 QoL questionnaire. The obtained data were analyzed using statistical tests such as the Independent t test and repeated measures of analysis of variance in SPSS V. 23. Comparing the scores obtained from the control and intervention groups in the eight areas of quality of life before and after the study revealed that the intervention of the family-centered empowerment model resulted in increased scores in seven areas and accordingly the overall quality of life. However, these changes were not significant in the control group. In line with other relevant studies, the results of the recent study indicate that the training based on the family-centered empowerment model can play an important role in the adoption of proper health behaviors and independence of the patients with permanent pacemakers. In sum, by implementing this model, the health of the patients with chronic diseases can be improved.

One of the goals of "Improving Productivity of Clinical Staffs’ Law" was to reduce the clinical nursing errors. Nurses' fatigue is one of the most important causes of clinical errors in night shifts. This study aimed to study "Improving Productivity of Clinical Staffs’ Law" and clinical errors in nurses working in night shifts in Ganjavian Hospital of Dezful, Dezful City, Iran, in 2017. In this descriptive-analytical study, records of nurses' clinical errors in the night shifts from 1992 to 1995 (since the enforcement of the "Improving Productivity of Clinical Staffs’ Law"), as well as the years 1988 to 1991 (before the "Improving Productivity of Clinical Staffs’ Law”) were checked out. The study data were collected using a demographic questionnaire and clinical errors checklist. The obtained data were analyzed using Chi-square test in SPSS version 22. The total number of clinical errors recorded in the night shift in terms of drug, diagnostic, care-therapeutic and laboratory aspects was 318 cases before the implementation of the health promotion plan. This figure increased to 746 in 4 years. The total number of clinical errors in comparison with the patients' numbers showed that the odds ratio before the implementation of the development plan was 0.72 and after the implementation of the plan and the risk of chance after the implementation of the development plan is equal to 1.38 before the implementation of the plan. The total number of clinical errors in relation to the number of nurses showed that the risk of risk before the implementation of the development plan was equal to 0.195 after the implementation of the transformation plan and the risk of the risk after the implementation of the plan to develop before the implementation of the plan is 5.12. Results showed that the implementation of the development plan and consideration of the reward for the transparent report of clinical errors increased the number of reports of clinical errors.