نشریه پرستاری مراقبت ویژه
سال دهم شماره 3 (پیاپی 35، Aug 2017)

The prevalence of suicide in Iran is higher than other West Asian countries.
The aims of the present study were to determine the prevalence of suicide attempt in psychiatric patients, and determine its associations with clinical and sociodemographic factors, and gender differences.
Participants in this descriptive-analytic study were 941 patients who were hospitalized for at least 2 days in Razi center in Tehran in 2010. Univariate and multivariate logistic regressions were used to analyze the factors related to suicide by SPSS software Version 17.
Almost 23.4% of the participants had a history of suicide attempt. Of the 250 females, 42 and of the 691 males, 178 attempted suicide. Suicide attempt in divorced, separated, and widowed females was much higher than in single females (P = 0.032). Also, those females who were drug abusers attempted suicide more often compared to non-users (P = 0.047). Suicide attempt was more prevalent in young males (P There were significant differences in suicide attempt risk factors between males and females with psychiatric disorders; these differences could not be related to different exposures to the known risk factors in the 2 genders.

There are contradictory results regarding the pattern of seasonal variations of acute myocardial infarction (MI). Documentation of such a pattern may contribute to identify new pathophysiological factors in the occurrence of MI. Therefore, the current study aimed at determining the association between MI and the admission season and time.
The current cross sectional, retrospective study was conducted on 286 patients diagnosed with MI admitted to Imam Sajjad (a.s) hospital in Ramsar, Iran, in a 5-year period from 01 July, 2012 to 31 July, 2016. Data of patients including age, gender, and admission hours, months, and seasons were collected from their records. Information on temperature and humidity was collected from Ramsar weather forecast center (Iran). Data analysis was done by SPSS version 18 through statistical tests.
The mean age of the study subjects was 68.12 ± 6.44 years. The highest admission rate was in summer (30.1%) in terms of season, and it was 35% at 12:00 P.M to 6:00 P.M in terms of time. Admission peak hours were at 10:00 AM, 11:00 AM, 1:00 P.M, and 2:00 P.M, respectively. There was significant statistical difference between MI in terms of season, and temperature and humidity average (P There was a seasonal rhythm in admissions for acute MI in the study with an increase in summer and a decrease in winter. In most of the studies regarding the effect of seasonal variations on the occurrence of acute MI, only the effect of temperature was studied. Due to the relationship between humidity and the occurrence of acute MI in the current study, it is recommended to conduct further studies by considering the 2 variables.

Nutrition is considered an important part of treatment in patients with chronic kidney disease (CKD). Therefore, poor nutrition leads to decreased life quality and increased complications of hemodialysis as well as mortality in these patients. This study aimed at investigating the effect of nutrition education program (NEP) on biochemical parameters among patients undergoing hemodialysis.
This quasi-experimental study was conducted on 30 patients who referred to hemodialysis unit at Ayatollah Taleghani hospital in Urmia province, Iran. The sampling method was purposive. Data were collected through interviews and data collection instruments consisted of demographic questionnaires and checklist. In the pre-education stage, the demographic questionnaire was completed and a 2- month average of biochemical parameters (sodium, potassium, calcium, phosphor, blood urea nitrogen, and creatinine) were measured and recorded in the checklist by the researcher. Then, the patients received four 30- minute educational sessions on nutrition using learning assistant tools. Two months after the education program, the laboratory results were measured and recorded again by the researcher. Data analysis was performed using SPSS 14 and paired t test, and significance level was set at 0.05 (P The findings revealed a significant decrease in sodium, potassium, calcium, blood urea nitrogen (P The implementation of nutrition education program (NEP) for patients under hemodialysis can improve biochemical parameters as well as complications resulting from their imbalance. Therefore, this program is recommended for this group of patients.

Weaning decision for the patients undergoing mechanical ventilation (MV) is often made based on personal judgments and experiences, which results in longer MV length of stay and higher costs. Therefore, the present study aimed to evaluate the effect of Burn’s wean assessment program on the success rate of weaning from ventilator in patients admitted to the Intensive care unit (ICU).
The present experimental study was carried out on 100 patients undergoing MV for more than 72 hours. The patients were selected by convenience sampling and randomly divided into two groups of 50 subjects. Burn’s wean assessment program was applied to the intervention group, while weaning was assessed by a physician in the control group.
35 patients in the intervention group were male and 15 were female. In the control group, 36 were male and 14 were female. Chi-square test showed no statistically significant difference between the two groups (P Using Burn’s scale for assessing patient readiness for weaning from mechanical ventilation is more useful.

Nursing is one of the stressful jobs and working in an intensive care unit is inherently stressful due to its active and dynamic features and complexity. One of the appropriate methods for decreasing stress is mindfulness training, therefore, this study aimed at assessing the effect of mindfulness training on nurses’ job stress level.
The present study was conducted in intensive care unit of Imam Hussein hospital (SA), a subspecialty hospital in Kermanshah in 2016. This was a pre- and posttest study with a control group in which 60 nurses were randomly and equally placed into 2 groups (control and experimental). Eight 90- minute mindfulness training sessions, one session per week, were provided to the experimental group. After the training sessions, the scale-revised questionnaire on nursing job stress was given to both control and experimental groups; and then, the effect of intervention was measured and compared between the 2 groups. Data analysis was done through descriptive and inferential statistical tests using SPSS 16 software.
A significant difference was found between average ± standard deviation of stress scores in the control group before (159.57 ± 20.56) and after (171.63 ± 21.39) mindfulness intervention (P = 0.001). Also, a significant difference was obtained between average ± standard deviation of stress scores in the experimental group before (165.28 ± 21.35) and after (118.20 ± 17.52) mindfulness intervention (P = 0.001). However, no significant difference was detected between the control (159.57± 20.56) and experimental (165.28 ± 21.35) groups in average ± standard deviation of stress scores before mindfulness intervention (P = 0.31). A significant statistical difference was found between the experimental (118.20 ± 17.52) and control (171.63 ± 21.39) groups after training (P = 0.001).
Mindfulness intervention can decrease job stress of the nurses who work in intensive care units. Therefore, considering the importance of nurses’ mental health, which influences quality of health care services and patients’ satisfaction, it is recommended that the health centers and hospital managers put mindfulness intervention training in their agenda.

Due to the severity of the patient's illness and high probability of death, in ICUs patients, it is necessary to point out the concept of death for the patients and families’ spiritual needs, for the implementation of the spiritual care at the end of life. The purpose of this study is designing and validating Islamic evidence-based spiritual care guidelines of the Sound Heart Model in dying patients.
This is a “developmental research” with an Islamic evidence-based as well as sound heart model approach, which was done on ICU patients of Baqiyatallah in 2016. Instructions were designed based on the Settler model in 4 phases: preparation, accreditation, comparative study, and application. The content validity of the instructions was assessed through the Delphi method by obtaining the opinions of 10 faculty members of different Universities. Applicability was assessed through focused group discussions with the comments of 10 experienced nurses in ICUs. The quality of the new guidelines was evaluated desirable, by Agree and Glia Tools.
Lack of preparation for death, fear of death, risk for quicken hard, and risk for grave horror were 4 nursing diagnoses of the dying patients. Four spiritual care instructions were designed and validated. Love to God and faith in God’s love for His servants, destroys the fear of death. For the owners of sound heart, death is a continuation of the soul's life and entering to a better world. They prepare for dying with a relaxed and confident soul as well as a hopeful and satisfied heart since they are going to meet God.
Negligence of nurses to spiritual care needs in dying patients can cause fear of death in patients and encounters their spiritual health with crisis. Therefore, it is recommended to apply these designed spiritual care instructions for dying patients that are muslim.

Diabetic foot problems account for more hospital admissions than any other long term complications of diabetes and are responsible for nearly 50% of all-diabetes-related hospital bed days. Maggot debridement therapy (MDT) offers important advantages for the management of chronic and infected wounds and is used in hundreds of clinics worldwide. This study aimed to evaluate the benefit of maggot debridement therapy (MDT) in the treatment of a patient with a diabetic foot ulcer (DFU).
A 46-year-old male patient with a 6-year-old diabetic foot wound in the right leg. Maggot larvae were placed on the wound. The patient was followed for 6 weeks and luckily had a good response to treatment.
This study concluded that MDT is as powerful as traditional debridement in the treatment of diabetic foot ulcers. It would be an achievable different option for diabetic foot ulcer treatment. In conclusion, we observed that MDT could promote wound healing by increasing endothelial proliferation, triggering angiogenesis, and maggot excretion/secretion, which might facilitate this process.