نشریه پرستاری مراقبت ویژه
سال چهارم شماره 1 (پیاپی 10، بهار 1390)

Faith therapy is one of the treatments which connect the patients with power of the Holy God so that the patient seeks healing and cure. This study aimed “to determine the effect of prayer in reducing severity and intensity of the patient's illness”. This was a two-group controlled clinical trial, purposive study with 70 subjects that was done in Intensive Care Units in 2010. The patients with chronic obstructive pulmonary disease and with congestive heart failure investigated. The patients in the intervention group were studied with recorded prayer for 3 days used prayer attributed to Prophet Muhammad (PBUH). No intervention was applied in the control group. To evaluate the severity of the patients’ illness, SOFA (Sequential Organ Failure Assessment) scale and for statistical analysis, parametric and non-parametric test was used through software SPSS 15. According to Mann-Whitney test, average difference of illness intensity of the patients between the first and the second day in the intervention group was -0.82± 92 (p>0.05) whereas between the first and the third day was -2.08±1.29 (p<0.001) and between the second and the third day was -1.25±0.91. Prayer therapy had a positive effect on reducing the severity of the patient's illness.

Triage is the basis of disaster management and teaching triage skills to the nurses is of high importance in disaster and calamity planning. This study aimed “to compare the effectiveness of two teaching methods of lecture and multimedia software on nurses learning”.

In a semi-experimental, two-group pretest-posttest study, ninety nurses of one of hospitals in Isfahan using random allocation method divided into two equal groups of education by lecture and by multimedia software in 2009. Learning of the nurses in cognitive and emotional areas was measured about triage using a researcher-made multiple choice test in three stages; before, after and recall stage after the intervention. Thereafter, the data were analyzed using independent t-test and repeated measures analysis of variance and SPSS 15 software.

Learning rate of the nurses about triage increased in two methods (p<0.001) but showed no significant difference between two groups (p>0.05). Significant difference wasn’t showed in mean total scores (cognitive and emotional areas) before the intervention in both groups (p>0.05), i.e. the two groups were homogeneous. But, at measurement of the second stage (posttest), mean total scores in the lecture group was higher than multimedia software group (p<0.001). In addition, in the recall stage, there was no significant difference in mean total scores (cognitive and emotional areas) between the two groups (p>0.05); however, mean scores of recall stage in the multimedia software group was higher than lecture group.

The results indicated the effectiveness of both lecture method and multimedia software method; however considering to the characteristics of the virtual learning including comprehensive interest-based learning, cost-effective, efficacy, accessible, flexible, appropriate design, and comprehensiveness and extendable, this effective method is recommended.

Currently, a few percent of Cardiopulmonary Cerebral Resuscitation (CPCR) has been successful which would lead to prolonged survival of the patients. Hence, this study aimed to review the effect of managing in-hospital cardiopulmonary cerebral resuscitation on the resuscitation outcomes. This was a pre and post quasi-experimental study. In the pre-intervention phase, eighty patients were studied in a selected educational hospital in Tehran who underwent CPR, in terms of short and long term resuscitation outcomes in 2009. The CPCR management process was conducted for five months. After stabilization of this new system, the resuscitation outcomes again were reviewed by another eighty patients. For recording short and long term resuscitation outcomes was used standard Utstein form. The statistical analysis was done by SPSS 16 software and descriptive-analytical statistical. The short term outcomes increased after the intervention from 18.8% (pre) to 31.3% (post) and the long term outcomes also were boosted from zero percent (pre) to 2.5% (post). Generally, after the intervention, 66.3% of the resuscitation were unsuccessful, 31.3% were successful in short term and 2.5% brought about the long term survival; and the patients with moderate to good brain function discharged from the hospital. This result had a significant difference with the situation of pre intervention phase (p<0.05). Performing the CPR management process can be applied as a model for performance of the managers of health-treatment centers to increase survival rate of the patients after the CPR.

While euthanasia is the most controversial subject in end-of-life care field, there is very little available information about psychological correlations of attitude towards it particularly in Iran. The present study aimed “to assess the acceptance rate of euthanasia and evaluate the role of personality and religious variables in attitudes towards euthanasia”. This was a descriptive-analytical study on 233 students of Tehran University. The data collection tools included the following questionnaires: euthanasia acceptance, euthanasia attitude scale, five-factor personality models and religious orientation scale. Furthermore, the participants studied the "Trolley Scenario" and judged about it. The data were analyzed using software SPSS and descriptive and inferential statistics including frequency, t-test, correlation and regression. The results indicated that 63.9% and 58.8% of the participants were opposed with active and passive euthanasia, respectively. The opposition rate with active euthanasia was more than the opposition rate with passive one (p<0.05). Sex and age of the participants had no association with acceptance of euthanasia and attitude towards it. Among the personality and religious variables, only the religious variables were associated (negatively) with attitude towards euthanasia. Besides, the judgment pattern of the pros and cons of euthanasia had not so much difference. According to the study findings, the majority of the Iranian students were opposed with euthanasia and their opposition with active euthanasia was more than that of the passive one. The role of religiosity in opposition with euthanasia was not affected by the personality factors. The findings of the present study in addition to emphasizing the difference of active and passive euthanasia, weakly supported the slippery slope argument.

Cardiovascular disease are the main causes of mortality among men and women so that the difference of acute myocardial infarction (MI) symptoms between men and women can affect on diagnosis and time of decision making for treatment and consequently on disease outcomes. Therefore, knowing different symptoms affects the prognostic of the disease according to the gender. This study conducted aimed to review the difference in clinical symptoms of myocardial infarction between men and women. In this cross-sectional study, 169 patients admitted to Cardiac Care Unit at Imam Reza Hospital in Amol diagnosed as acute MI in 2009. Collecting the data was conducted using a demographic data form and symptoms check list and acute myocardial infarction symptoms were evaluated through interview. The data also were analyzed using Software SPSS 16, descriptive statistical methods and odds ratio. Female gender increased the ratio of weakness to 2.76, vomiting to 1.96, fatigue to 2.47, and anxiety to 2.20 and hiccups to 2.27. Furthermore, female gender increased the ratio of pain associated with acute myocardial infarction in jaw to 3.49, neck to 2.78, throat to 3.24, and shoulder to 2.43 and the left scapula to 2.83. Atypical symptoms, particularly in females, may cause delay in referring of the patients and also delay in decision making for diagnosis and treatment by the medical team. Hence, staff and patients of ICUs need more special information about recognizing acute myocardial infarction symptoms, especially with regard to the gender.

Birth of a premature infant is associated with separation from family and hospitalization. Actually, parents would undergo a lot of stress. The present study aimed to determine stressor agents of the mothers with premature infants admitted to the Neonatal Intensive Care Units (NICUs). This was a descriptive study with 140 mothers with premature infants admitted to the NICUs of three educational medical centers affiliated to Tehran University of Medical Sciences using Parental Stressor Scale (PSS) Questionnaire of Miles and Funk (1998). The data analyzed using descriptive-analytical statistical method and SPSS 16 software. Among the cases related to environmental stressor agents, the following items were reported as the most experienced stressor agents by mothers: breathing apparatus for infants (27.9%), the sudden sound of the monitor buzzer (25.7%) and cases related to appearance and behavior of the infant and special treatments such as stop breathing (70.7%), sudden skin discoloration of infant (55%) and cases related to parental-neonatal relationship such as separation from the infant (69.3%) and feeling helpless to protect the infant from pain and painful procedures (60.7%). Furthermore, the aspect of “appearance and behavior of the infant and special treatments” was more stressful in comparison with other stressor aspects. According to study findings, it is suggested to provide necessary preparations after the birth for parents (particularly mothers) with premature infants to face with the infants and make appropriate relation with them in NICUs.

Oral hygiene is one of the main tasks of Intensive Care Unit’s Nurses.This study aimed to determine the affecting factors of oral cares interventions and its documentation in Kerman University of Medical Sciences intensive care units. In this cross sectional study, all the nurses of intensive care units of Kerman University of Medical Sciences hospitals were surveyed and 131 responded. Oral cares questionnaires, underlying factors and nursing reports assessment check list were used to collect the data. Data were analyzed using descriptive and analytic statistics and PASW 18 software. Oral rinse was the most frequent method (82.4%) and the most used solution was chlorhexidine (43.2%). Documentation of oral care was done by most of the nurses but the information about used methods and outcomes were not provided. There was a direct relation between intensive care work experience) r=0.332; p<0.05 (and priority of the oral care (rho=0.349, p<0.001) with oral care quality. Viewing oral care as a difficult and unpleasant task had an indirect relation with oral care (p<0.05). There was need for education and informing nurses about importance of the oral care and evidence-based methods of oral care.

Evidence-based clinical guidelines are important tools in increasing the quality of clinical practice nurses. Hence, this study aimed “to review quality of evidence-based clinical guidelines of nurses’ view”. In this cross sectional study, 116 nurses participated in census method from the intensive care units of one of the selected hospitals in Tehran in 1389. For data Collecting used questionnaire that were made by researcher. Face validity was examined by nurses and content validity was examined by faculty members and the reliability of this test was confirmed by test retest and using McNemar and Spearman tests (r=0.72). The data analyzed using descriptive-analytical statistical method and SPSS 17 software. It was just observed significant relationship score (p=0.04) between variable marital and quality guideline. % 53.4 of nurses expressed that quality guidelines were good; % 39.7 moderate and %6.9 weak. Despite of this that about half of the nurses expressed quality guidelines were good, but up-to-dating the existing guidelines provide specific instructions for implementing the instructions in each section can be felt.