Iranian Journal Of Medical - Surgical Nursing
Volume:4 Issue: 3, 2015

spiritual care is considered as a part of the holistic care and rehabilitation specialists put much emphasis on paying attention to the spiritual needs in cancer patients. The present study aimed to explain the process of spiritual care in rehabilitation of cancer patients. This grounded theory study was done in 2012 in one of the hospitals in Tehran. The participants were 28 people، including cancer patients (11) and their families (7)، oncology nurses (6)، physician (1)، psychologists (2) and clergy man (1). At first، purposeful sampling was used and then، according to emerged codes and categories، theoretical sampling was employed. Data gathering was done through individual semi-structured interview، observation، writing field notes and using the documentation. Data were analyzed by Strauss and Corbin's approach. Data analysis led to emerging the 4 main categories including helplessness، seeking for support، attaining to relatively sense of spiritual well-being and effective factors on spiritual care. «Need for support» was identified as the core concept of the research. The support of rehabilitation caregivers (family and nurses) alongside the support of the patients، and forming the spiritual care team including physician، nurse، social worker، psychologist and clergyman is essential.

Ventilator associated pneumonia (VAP) is one of the most prevalent hospital infections in intensive care units. Mouthwash is one of the caring procedures which can be effective in decreasing the rate of VAP. The present study was conducted to determine the effect of Echinacea mouthwash on prevalence of ventilator associated pneumonia in intensive care units. In this clinical trial study, population was the intubated patients in intensive care units of educational hospitals in Arak in 2014. 70 patients were selected purposively and then were randomly allocated into two intervention and control groups, In intervention group, mouthwash with Echinacea and in control group with normal saline was done twice daily. The rate of VAP was assessed by Clinical Pulmonary Infection Scale (CPIS), before and on the fifth day of intervention. Data were analyzed by Chi square, independent T-test and fisher’s exact test through using SPSS16. prevalence of Ventilator associated pneumonia was 60 percent in normal saline and 51.4 percent in Echinacea group; buth the Chi square test didn’t show significant difference between two groups. According to results, Echinacea can relatively decrease the rate of VAP in ventilated patients, but more investigations in this area are essential.

Care of patients undergoing coronary artery bypass graft (CABG) creates some concerns for family caregivers. Increasing the ability of caregivers as accompanies the patient is essential.The purpose of current study was to determine the effect of education with the partnership approach on the self-efficacy and self-esteem of family caregivers of patients undergoing coronary artery bypass graft. In this clinical trial study 102 caregivers of the hospitalized patients in cardiac surgery ward in one Hospital in Tehran, 2011 were selected through convenience sampling and randomly allocated into two intervention and control groups of 51 people. For intervention group, 5 sessions educational program with partnership approach were conducted. Self-efficacy and self-esteem of caregivers were measured before and 8 weeks after intervention through using the researcher-made questionnaires. Data analysis was done through PASW 18 Statistics and using independent and paired t-test, chi-square and Fisher exact test. In intervention group, the mean score of caregiver’s self-efficacy was significantly increased from (29.49 ± 3.89) to (47.43 ± 1.93) (P < 0/001). As well as the mean score of caregiver’s self-esteem was increased from (93.49 ± 6.03) to (126.13 ± 18.52) (P < 0/001). Also, the results of independent t-test showed the significant difference concerning the self-efficacy (p < 0.001) and self-esteem (p < 0.002) between two groups. Education of family caregivers of patients undergoing coronary artery bypass graft with a partnership approach can lead to improvement the caregivers’ self-efficacy and self-esteem and thus the increasing of their participation in efficient care. Therefore, application of this method is recommended in the educational process

Cancer is one of the chronic diseases with increasing prevalence in children that has many psychological outcomes one of these consequences is depression. This study was conducted to determine the effect of aerobics on mild depression in children with cancer. The current research was a quasi-experimental study. Study population was all of the 7-12 years old children with cancer who were hospitalized in the oncology ward of the one of the hospitals in Tehran in 2014. Depression in children was measured through Kovacs’ “Children Depression Inventory and 31 eligible children were selected through convenience sampling. Intervention was done as 6 group sessions of 45 minutes with the implementation of aerobics in playroom. Depression of children was measured again in the last day of intervention (sixth day) and also three weeks later. The data were analyzed through using repeated measures ANOVA, independent T-test, Pearson’s correlation and one-way ANOVA in the SPSS18. The results showed that the mean score of depression in children has significantly decreased after the intervention (8.64 ± 1.63) and three weeks later (8.35 ± 2.11) in compare with the before the intervention (11.71 ± 1.94) (P < 0.001). The results revealed that the aerobics as a non-pharmacological intervention can reduce the mild depression in children with cancer. Therefore, it is recommended to restore the health and vitality of hospitalized children.

Delirium has a high prevalence after cardiac surgery. Many studies were conducted on the etiology of delirium after the cardiac surgery, but its definitive reason has not expressed. Because the high percentage of these patients experience severe pain, this study was conducted to determine the relationship between pain and the incidence of delirium in patients undergoing cardiac surgery. This descriptive-analytical study was conducted on 40 patients undergoing cardiac surgery in one of the educational hospitals in Tehran in 2014. Patients were selected through convenience sampling. The incidence of delirium in patients was assessed twice daily on the second to fifth day after surgery through the CAM-ICU scale (Confusion Assessment Method -ICU). Also pain was assessed on the second post-operative day in two times, during the rest and during the nursing procedures through the Critical Care Pain Observation Tool (CPOT) in intensive care unit. Data were analyzed by using SPSS 16 and through the chi-square and Fisher's Exact Test, Mann-Whitney and McNemar test. Incidence of pain and delirium after the cardiac surgery was 95 and 45 percent respectively. 2.5 percent of patients experienced pain during rest and delirium together, while 20 percent of patients had suffered from delirium and pain during the nursing procedures. According to Fisher's Exact Test, this relationship was not significant, but there was significant relationship between some indicators of pain such as body movement (p=0.008) and muscle tone (p=0.02) with incidence of delirium. According to the results, there is no relationship between pain and incidence the delirium. Due to high levels of pain and delirium, it is proposed to implement the nessecary actions for reducing the incidence of these complications.

Diabetes is associated with many complications that one of these complications is neuropathy. This disease is more common in women. In cases of self-care deficit and not meeting its related needs, the disease can lead to complications and even death. This study was done to determine the self care ability of diabetes women with peripheral neuropathy and its related need based on Orem self care model. This cross - sectional study was conducted on women with diabetic peripheral neuropathy who referred to diabetes clinic in one of the hospitals in Gonabad in 2014. 120 patients were selected by convenience sampling. Patients’ neuropathy was determined by Michigan Neuropathy Screening Instrument and Toronto Clinical Neuropathy Score. Then, data were gathered through using self care needs assessment questionnaire and self care ability questionnaire based on Orem self care model. Data analysis was done through using descriptive statistical test and chi-square test with in SPSS 17. The self care ability of 71.7 percent of patients was weak (33.72 ± 8.48) and according to needs assessment and in domains of knowledge, attitude and performance, 10.8, 0.8 and 52.5 percent of subjects were weak respectively. According to the findings, the self care ability of diabetic women with peripheral neuropathy was weak. The domain of performance was weaker than attitude and knowledge domains concerning the self care ability. Therefore, it is recommended to design and implement of necessary measures for improving the patients’ self care ability based on their needs.

Patients with spinal cord injury suffer from continuous and persistent neuropathic pain that has a destructive impact on their quality of life. Exercise therapy is one of the non-pharmacological interventions that is recommended to control chronic pain, This study aimed to determine the effect of exercise program on neuropathic pain intensity in patients with paraplegia Spinal Cord Injury. This study is a clinical trial.that population was the all of the patients with spinal cord injury, who referred to one of the educational hospitals in Tehran in 2014, 40 patient were selected based on purposive sampling and were randomly allocated into two groups of experimental and control. Exercise program for paraplegia spinal cord injury was implemented in experimental group during twelve 45-60minutes sessions, twice a week. Data collection was done before and one week after the intervention through using personal information form and, The International Spinal Cord Injury Pain Basic Data Set. Data were analyzed with statistical software SPSS19 and Fisher's exact test, Independent samples T-test Paired T-test and Chi square. The mean score of neuropathic pain intensity before the intervention was 8.05 ± 1.51 in intervention group and 7.57 ± 1.21 in the control group. These amounts after the intervention were 5.55 ± 1.61 and 7.37 ± 1.05 respectively (p < 0.001). Results showed that the regular exercise program can reduce neuropathic pain severity in patients with spinal cord injuries and it can be recommended as a non-pharmacological method of pain control in these patients.