Iranian Journal Of Medical - Surgical Nursing
Volume:3 Issue: 1, 2014

Although receiving transplantation improves quality of life in patients with end-stage renal disease، but faces them with new challenges. During the process of coping with transplanted kidney، there are several factors facilitate or obstacle this process. This study aimed to determine the facilitators of coping with transplanted kidney in renal transplant recipients. In this qualitative study، during 2011-2012، in-depth semi-structured interviews were done with 11 renal transplant recipients in transplantation ward of Afzalipour Hospital affiliated to Kerman University of Medical Sciences، Iran. The purposive sampling continued to emerge statured data، codes and themes. Data analysis was done using the latent content analysis approach. Analysis of the text revealed 2 themes and 7 categories including using internal resources (spirituality، positive thinking، and positive self-image) and using external resources (family، peers، health care system، and social organizations). Internal and external resources assist kidney transplant recipient to cope with transplanted kidney. Developing social supportive systems as well as family education about their important role that could positively affects the process of coping should be considered. Providing an environment in which the patients can express their experiences of coping under supervision of expert nurses seems to be an effective approach to make them aware of effective coping strategies and provide an atmosphere to learn from each other.

Premenstrual syndrome (PMS) is a common disorder in women of reproductive ages. Regarding the unknown etiology of this syndrome، several treatments are recommended; one of them is use of medicinal herbs. This study was carried out to evaluate the effects of Ginger on severity of symptoms of premenstrual syndrome. In this double-blind clinical trial study، 70 students from Tehran University of Medical Sciences، Iran، which suffered from premenstrual syndrome were randomly assigned to Ginger and placebo groups in 2013. Participants received two capsules daily from seven days before menstruation to three days after it for three cycles and they recorded severity of their symptoms. Demographic information form and daily record of symptoms questionnaire were data collection tools. Data of before interventions and 1، 2 and 3 months after it were analyzed using repeated-measurement analysis of variances and indepented t tests via SPSS18 software. P < 0. 05 was considered significant. Before intervention، there were no significant difference (P = 0. 710) between the mean scores of symptoms of premenstrual syndrome in the two groups (110. 20 ± 30/77 in Ginger and 106. 70 ± 44. 65 in placebo groups). But at 1، 2 and 3 months after intervention، there were significant differences (P < 0. 001(between the mean scores of symptoms of premenstrual syndrome in the two groups (105. 70 ± 45. 76، 107. 20 ± 50. 68 and 106. 00 ± 48. 74 in placebo، and 51. 18 ± 32. 76، 49. 48 ± 33. 12، and 47. 06 ± 33. 41 in Ginger groups، respectively). Based on results of this study، Ginger may be effective in reduction of severity of psychological، physical and behavioral symptoms of premenstrual syndrome. However، therapeutic use of these drugs needs further studies.

One of the problems of premature infants is oral muscles insufficiency and inadequacy of oral-feeding skills at birth. Use of supportive oral interventions such as olfactory stimulation can facilitate this increasing challenge in neonatal intensive care unit. This study aimed to check the effect of olfactory stimulation with breast milk smell on the duration of feeding transitional time from gavage to oral feeding in premature infants. In this randomized clinical trial study، 92 premature infants with the gestational age of less than 33 weeks hospitalized in neonatal intensive-care units of Valiasr and Jame Zanan hospitals in Tehran، Iran، during April to September 2013 were enrolled using available sampling method. They were randomly divided into 2 groups of 46، control and intervention (received mother milk odor during gavage periods) groups. A researcher-made checklist including demographic and primary (transitional feeding time، weighting، first breast feeding time، hospital stay) variables was used. The data were analyzed using independent t and Mann-Whitney tests via SPSS16 software. Olfactory stimulation of premature infants significantly reduced the feeding transitional time and length of hospitalization more in intervention group (11. 20 ± 3. 23 and 14. 65 ± 3. 57 days، respectively) compared to control group (21. 65 ± 6. 04 and 26. 20 ± 6. 50 days، respectively) (P < 0. 001 for both). Starting the first breast-feeding from mother''s breast was done more effectively in a shorter time in intervention group، too (P < 0. 001). According to reducing the gavage to oral feeding transitional time، training this simple and low-cost method to mothers can be effective in improving the quality of feeding in premature infants.

The role of desirable control of diabetes in preventing disease outcomes is well-known. Considering the importance of identificating the effective factors on control of diabetes، the present study was conducted to determine the importance of metabolic control and related factors in patients with type 2 diabetes mellitus attending in Shahroud city diabetes center، Iran. This analytical-descriptive study was conducted on 156 patients with type 2 diabetes mellitus refered to Shahroud city diabetes center in 2013. Metabolic control was determined based on hemoglobin A1C and divided into three levels of poor، intermediate and appropriate controlled. Then، its relationship with individual characteristics and disease-related factors was evaluated. Data analysis was done via SPSS16 software using Pearson correlation coefficient، independent samples t and One-Way ANOVA tests. Mean of hemoglobin A1C was 8. 14 ± 1. 62 and most of the patients had a moderate level of metabolic control (7-10%). There was a significant relationship between level of metabolic control and marital status (P < 0. 001)، lifestyle (P < 0. 001)، level of education (P < 0. 001)، jobs (P < 0. 001)، income (P < 0. 001)، smoking (P < 0. 001)، exercise (P < 0. 001)، the time of diagnosis (P = 0. 010)، associated complications (P < 0. 001) and the type of drugs (P = 0. 010). But there was no significant relationship between the level of metabolic control and sex (P = 0. 110). Considering that most of the patients did not have optimum control and according to the relationships of factors such as marital status، lifestyle، smoking and exercise with metabolic control in these patients، it seems that the implementation of educational programs for patients and influence of families to support them، make achieving appropriate levels of metabolic control easier which results reduction of complications and problems of patients with type 2 diabetes mellitus

Care of the low birth weight (LBW) neonates in incubators is accompanied with effects such as delay in weight gain، prolonged hospitalization and caused hospital infections accordingly. One of the substitutive methods of incubator care is natural and non-invasive kangaroo mother care (KMC) in which infant are in skin-to-skin contact whit mother. In this study، it was aimed to review the effect of kangaroo mother care on weight gain، stay length and control of temperature with low birth weight in preterm neonates. This clinical trial study was conducted on preterm neonates with the history of birth weight lower than 2500 in neonatal intensive care unit (NICU) of selected hospitals in Moshhad، Iran، in 2010. Fifty neonate were selected regarding to purposive sampling and were assigned into two groups (25 in intervention group، and 25 in control group). In the intervention group، infant and mother have skin-to-skin contact one hour a day. In the control group، the infant cared and fed according to routine schedule in NICU unit. The temperature degree was measured in two periods. The data were analyzed by chi square، independent t-test and analysis of variance (ANOVA) repeated measurements. The mean of weight changes in the KMC group was 15g and 4g in control group which were statistically significant difference between the two groups (P = 0. 015). The mean staying period in the KMC group was 7. 9 and 10. 6 in control group which was statistically significant difference between the two groups (P = 0. 03). The changes of temperature in the two groups were not statistically significant. KMC method had positive effect on gaining weight of preterm neonates and reduced hospitalized days in the NICU. It is recommended that health authorities act towards training KMC method to nurses and healthcare team members as obstacles to be overcome.

Diabetes mellitus is an important risk factor for heart diseases. Cardiovascular autonomic neuropathy as a diabetes mellitus complication can impair recognition of myocardial ischemia or infarction. This study aimed to compare the quality of perceived myocardial infarction (MI) pain in patients with or without type 2diabetes mellitus. In this analytic cross-sectional study، 180 patients with or without type 2diabetes mellitus with acute myocardial infarction were included. They were selected from 3 hospitals of Mashhad University of Medical Sciences، Iran، in 2011 by non-randomized convenience sampling. We used researcher-made forms for selecting the samples، recording demographic variables، history and present disease such as pain characteristics، the electrocardiogram and laboratory results، and also standard visual numeric scale (Mc-Melzac questionnaire) for assessing the presence and intensity and location of pain. Data were analyzed usingindependent t، chi-squared، and Mann-Whitney tests in SPSS17 software. 76. 4% of subjects were men، 50. 6% were with and 49. 4% without type 2 diabetes mellitus. Although the mean of intensity of pain of myocardial infarction in patients with diabetes was lower than those without it، but these differences were not statistically significant. There was no statistically difference between the two groups in type، location، radiation، duration and type of myocardial infarction. There was no relationship between the perceived pain intensity and duration of diabetes or history of myocardial infarction. The results of this study on the characteristics of the location of infarction and its severity and duration and pain location and its distribution showed no difference between the patients with a 5-years history and without type 2 diabetes mellitus. Due to the constraints of this cross-sectional and importance of pain in diagnosis of myocardial infarction، more studies with more control and patients with history of type 2 diabetes longer than 5 years is recomended.

Hypertension is the most common risk factor for cardiovascular disease in elderly. This study aimed to determine the effect of short-term aerobic exercise on blood pressure in elderly with hypertension. In this clinical- trial controlled study، 92 elderly clients with the age of 65-75 years were selected in Shiraz city، Iran، in 2011، according to inclusion criteria of study and divided into two equal groups of control and intervention. The intervention consisted of 4-week walking periods، three times in one week، each time 20-30 minutes. Data were collected using calibrated mercury sphygmomanometer. The Reliability of mercury sphygmomanometer was confirmed by intra-rater consistency. The data were analyzed using paired and independent t test via SPSS 16 software. There was no statistically significant difference between the groups in means of systolic and diastolic blood pressures before intervention. After the intervention، mean of systolic blood pressure decreased significantly from 149. 88 ± 4. 16 to 144. 93 ± 5. 21 (P = 0. 004) and diastolic blood pressure decreased significantly from 94. 03 ± 3. 16 to 85. 9 ± 6. 38 (P = 0. 030) in intervention group; but there was no significant change in control group. The findings showed that walking is an effective nursing intervention for reducing blood pressure in elderly patients with hypertension.

After-discharge follow-up care is one of the most important strategies to help patients with heart failure to prevent worsening of the disease. This study aimed to compare the patient education and follow-up by nurse on anxiety in patients with heart failure referred to Rajaei cardiovascular center، Tehran، Iran. In this clinical trial study، 189 patients with heart failure were selected using purposive sampling method and randomly divided into 3 groups in 2012. The control group received only hospital routine care. The first intervention group received one hour of discharge education and one educational booklet at the time of discharge and second intervention group received telephone followed-up by nurse 3 months after discharge in addition of receiving one hour discharge education and educational booklet at the time of discharge. Data collection tools included Beck anxiety and a researcher-made demographic questionnaire. Data were analyzed using chi-square and one-way ANOVA tests via SPSS18 software. The means of anxiety scores were 21. 9 ± 11. 5 and 11. 0 ± 7. 6، 19. 2 ± 9. 7 and 19. 6 ± 9. 2، and 18. 9 ± 6. 9 and 18. 7 ± 11. 7 before and after the intervention in first and second intervention and control groups، respectively. Before the intervention، there was no significant between means of anxiety scores in 3 groups (P = 0. 168) but after the intervention، this difference was significant (P < 0. 001). After 3 months of telephone follow-up by nurse، there was a significant reduction in patients’ anxiety scores. So، this kind of cost-effective follow-up intervention after discharge can reduce anxiety in patient with heart failure.