Iranian Journal Of Medical - Surgical Nursing
Volume:7 Issue: 1, Feb 2018

Pain and weakening of muscle strength are the most important problems in orthopedic patients. Isometric movements are effective in reducing these problems. Due to the lack of studies in this field, this study was conducted with the aim of investigating the effect of isometric movements on pain control and muscle strength reversal of lower limb fractures.

This clinical trial was carried out in 120 patients aged 15 - 49 years suffering from lower limb fracture admitted to the Shahid Beheshti hospital of Sabzevar in 2016 with random allocation to intervention and control groups. In the intervention group, physiotherapy was performed by isometric movements four hours after the surgery and then, up to five consecutive days, each day four times of half an hour. The amount of pain and reversing muscle strength was investigated before and after the intervention in both groups. STATA 11 software was used to analyze the data at a significance level of 0.05.

In the intervention and control groups, there were 83% and 85% males, 17%, and 15% females, respectively. The age groups of 40 - 49 years (37%) and 30 - 39 years (35%) were the most frequent. The Wilcoxon test showed a significant difference between the amount of pain before (6.86 ± 1.18) and after (2.86 ± 1.89) the intervention (P < 0.001). Fischer’s exact test showed a significant difference between the groups in terms of muscle strength after the intervention (P < 0.001).

Isometric movements exercise is the most effective method for relieving pain and reversing muscle strength, which can be recommended by orthopedic doctors because it facilitates recovery and accelerates the return to normal life.

One of the main issues regarding the management of chronic diseases is patients’ non-adherence to treatment regimens. An important factor affecting treatment adherence is social support. This qualitative study was aimed at exploring the role of perceived social support in adherence to treatment regimens among patients with chronic diseases. A qualitative study was carried out on 34 patients with chronic diseases, who were purposively recruited from the targeted cities of Bushehr and Tehran, Iran. In-depth non-structured interviews were conducted for the process of data collection from June 2014 to November 2015. Data were constantly and simultaneously analyzed as they were being collected, using the content analysis approach. The data collected in this study yielded four themes that included: having the wholehearted support of a spouse, living with supportive family members and significant others, obtaining information, and confiding in physicians. These themes showed the dimensions and the types of patients’ perceived social support. The study’s findings imply that the most important and common sources of perceived social support among Iranian patients with chronic illness are their spouses, relatives, and friends. According to the results, the participants realized that social support could help them in adhering to their treatments and coping with their illness. Identifying types of perceived social support allows health professionals, especially nurses, to use such information for developing and implementing evidence-based care plans and organizing support systems in order to enhance patients’ adherence to treatments

Injections are common nursing interventions, which usually cause pain. The pain caused by injection causes anxiety, discomfort, and reduced patient confidence in nursing performance. Since applying methods that enhance patients’ comfort is a nursing task, the aim of this study was to determine the effect of EMLA cream and diclofenac gel on pain caused by needle port placement in patients undergoing chemotherapy at the oncology department. This cross-sectional clinical trial study was conducted on 40 inpatients of the Oncology Ward of Khatam-al-Anbia Hospital in Zahedan, during year 2017. Patients were selected by conventional sampling, based on the Inclusion criteria of the study. Patients were randomly assigned to use EMLA cream, diclofenac gel or the placebo. The severity of pain was measured immediately after injection, using the visual analogue scale (VAS). Blindness was done for pain the assessor and data analyzer. The SPSS 22 software was used for statistical analysis. First, descriptive statistics were used to determine the frequency, percentage, and mean, and then inferential statistics of paired t-test, for group comparison. The mean scores of the severity of pain in three groups of EMLA, diclofenac gel, and placebo were 5.49 ± 2.05, 5.88 ± 1.93, and 6.71 ± 1.96, respectively. Comparison between diclofenac gel and placebo showed that the mean decrease in pain intensity in the diclofenac gel group was far more than the placebo (P < 0.0001). Comparing EMLA cream and placebo, the mean reduction in pain intensity in the EMLA cream was far higher than the placebo (P < 0.0001). Finally, the EMLA cream was more effective than diclofenac gel in pain reduction, although the difference was not statically significant. Although the use of EMLA cream and diclofenac gel can reduce pain at the injection site, applying diclofenac gel is recommended due to its availability, cost-effectiveness, and domestic production.

Parents of children with thalassemia major, as the main caregivers, encounter numerous challenges in coping with various and complicated problems due to the disease of their children. Although the coping strategies of the parents regarding the illness of their children are of high importance, a few studies have been performed on this subject. Therefore, the present study aimed to determine the coping behaviors of parents of children with thalassemia major.

This cross-sectional study was performed on parents of 103 children with thalassemia major, who referred to the thalassemia clinic of Hazrat-e-Ali Asghar, Zahedan, Iran in 2016. The data were collected using a demographic questionnaire and the coping health inventory for parents (CHIP). The total score and scores of coping behaviors were evaluated in three coping patterns subscales. The mentioned subscales included ‘‘family integration, cooperation, and optimism’’, ‘‘social support, self-esteem, and mental stability’’, and ‘‘medical communication and consultation’’. All the data were analyzed using descriptive statistics and independent t-test by SPSS version 22.

The coping behaviors that were not mostly carried out by mothers and fathers were “I talk to other parents who are in similar conditions and learn from their experiences” (63.1%) and "I talk to the healthcare team” (73.8%). The mean total score of the CHIP was 51.76 ± 24.65 and 54.79 ± 26.41 for mothers and fathers, respectively. There was no significant difference in the mean total scores and the scores of the three coping patterns between the parents.

According to the findings of this study, the parents achieved scores low than the normal scores in all the three coping behaviors subscales. Effective coping behaviors in the parents of children with thalassemia major seem to be highly important. Consequently, appropriate educational-supportive interventions for parents and continuous monitoring are essential for improving the coping behaviors in this group.

Fatigue is a debilitating complication in hemodialysis patients. Foot reflexology is one of the complementary medicine techniques with low complications that can control fatigue.

The aim of this study was to determine the effect of foot reflexology massage on fatigue severity in hemodialysis patients.

In this clinical trial, 90 patients undergoing hemodialysis at Ali ibn Abi Talib hospital in Zahedan, Iran, in 2017 were randomly selected and then divided into two groups of intervention and control (n = 45 per group). The data collection tools included a demographic checklist and the fatigue severity scale developed by Krupp et al. Foot reflexology massage was performed in the intervention group for half an hour (15 minutes for each foot) by a trained researcher for three consecutive dialysis sessions. After completion of dialysis sessions, a questionnaire was completed as post-test in both groups. For data analysis, independent t-test, paired t-test, and chi-square test were run in SPSS, version 21.

There was no significant difference in the mean fatigue scores between the control and intervention groups before foot reflexology massage in the three sessions of dialysis. After the intervention, the independent t-test showed a significant difference in the mean fatigue score between the control and intervention groups (P < 0.001).

The findings of this study showed that foot reflexology massage is an uncomplicated technique for reducing fatigue severity in patients undergoing hemodialysis

Postoperative hypothermia is a common and important complication of anesthesia and surgery that negatively affects the mother and the neonate. Therefore, the present study was conducted with the aim of investigating the effect of the hypothermia prevention program on central temperature changes and hemodynamic parameters in women undergoing cesarean section.

In this two group quasi-experimental study, 92 pregnant women were conveniently selected, who were candidates for cesarean section under spinal anesthesia in Ali Ibn Abi Talib hospital, Zahedan, Iran, 2017. Then, they were allocated randomly in two intervention and control group. The intervention group received a hypothermic prevention program. Central temperature, blood pressure, and pulse rate of the patients were measured and recorded seven times. Data analysis was performed using repeated measures analysis of variance in SPSS software, version 21.

The results showed that the pattern of temperature changes in the groups was significantly different over time (P = 0.001). However, there was no significant difference between the groups considering the hemodynamic parameters.

The hypothermia prevention program is effective in reducing the central temperature loss and can reduce its severity after the surgery in women undergoing cesarean section

Female reproductive system injury caused after vaginal delivery is very common, and episiotomy and spontaneous tears, or both are the most important contributing factors in this regard. However, several techniques have been developed to reduce this damage, yet their impact has not been fully proven. Therefore, the present study was conducted to determine the effect of perineal heating pad on the frequency of episiotomies and perineal tears in primiparous females. In this single-blind clinical trial, a total of 114 primiparous females, who referred to Imam Ali Hospital in Andimeshk and were eligible to participate in the study, were randomly divided to two groups, consisting of 57 individuals. The heating pads were used in the intervention group with the start of the second stage of labor and the childbirth process was routinely carried out in the control group without any intervention. The data collection tool was a form on demographic information and characteristics of the research subjects, as well as the maternal postpartum data collection form. Data analysis was carried out using Chi-square and independent T-test using the SPSS software version 19. P values of < 0.05 were considered significant. The frequency of episiotomies was 41% and 21% in the control and intervention groups, respectively. There was a significant difference between the two groups in this regard (P = 0.025). The results also showed that the perineal intactness percentage was higher in the intervention group than the control group, although this difference was not statistically significant (P = 0.512). The results of the current study revealed that the use of perineal heating pad during the second stage can be effective in decreasing the episiotomy rate and improving perineal intactness in primiparous females. Since there are a few studies in this regard, it is recommended to carry out further research in this field and other interventions affecting perineal tear and the episiotomy rate