نشریه پرستاری مراقبت ویژه
سال نهم شماره 2 (پیاپی 30، May 2016)

Palliative care is essential for cancer patients. Palliative care programs reduce distress, promote patients’ improvement, increase family satisfaction, reduce hospitalization time and finally reduce costs and increase productivity.
The aim of this study was to compare the effect of palliative care and routine care on the satisfaction level of family members of patients with end stage cancer.
Patients and This quasi-experimental intervention study was conducted in two teaching hospitals of Tehran during year 2014 through convenience sampling on 80 families of patients with end stage cancer. The intervention group received palliative care and the control group received standardized routine care for at least three months. The Famcare questionnaire was used for assessing family satisfaction and statistical t-test and chi-square analysis were used for analyzing the data.
The mean satisfaction of the family members in the intervention and control groups was respectively, 82.8 ± 7.8 and 65.8 ± 9.07, which was statistically significant (P = 0.001). The patients’ family satisfaction of palliative care in the intervention and control groups was respectively 62.5% and 12.5%.
The level of family members’ satisfaction of palliative care was more than routine care. The findings of this study help nurses learn more about palliative care of cancer patients and consequently improve nurses’ performance and increase patients’ families’ satisfaction.

One of the most common problems in intensive care units (ICUs) is pressure ulcer or bed sore and its prevention is a priority in nursing cares.
The current study aimed to evaluate the effect of henna (Lawsonia inermis) on prevention of pressure ulcers in patients in ICU.
Patients and The current randomized clinical trial was conducted on 80 patients with the inclusion criteria hospitalized in the ICU of Al-Zahra hospital, Isfahan, Iran in 2015. Patients were randomly allocated into two groups of control (40 patients) and intervention (40 patients) by drawing method. For the intervention group, along with the standard prevention cares for pressure ulcers, once a 15 cm thick layer of henna was applied on patients’ sacrum. Data was gathered using demographic data questionnaire, Braden scale to predict pressure ulcer risk and the table to control daily record of skin temperature before the intervention for a week. Data were analyzed using SPSS ver. 21 and Chi-square, Greenhouse Geisser, Pearson correlation coefficient and independent t-test were used in the study.
The mean age of patients in the intervention and control groups was 51.35 ± 17 and 52.94 ± 19.61years, respectively. The means of standard deviation score of the Braden scale for all the participants on the first, fourth and seventh day of the study were 12.27 ± 2.85, 14.23 ± 3.21 and 15.73 ± 3.82, respectively, which had significant differences with each other (P Considering the effect of henna in reducing the local warmth, redness, and inflammation of sacrum in patients in intensive care units, application of henna to prevent pressure ulcers for patients at risk of developing pressure ulcers is recommended.

The lack of awareness about sexual activity after a myocardial infarction (MI), as well as consequent occasional sexual withdrawal and sex problems, are the key factors that intensify the stress, anxiety, and depression in patients with MI and their spouses.
This study aimed to investigate the effect of “sex education” on stress, anxiety, and depression in patients and their spouses after MI.
Patients and This randomized clinical trial was conducted on 60 patients hospitalized with ischemic heart disease along with their spouses. The intervention included five sessions of face to face training and offering an educational pamphlet. The Dass-21 questionnaire was completed for both groups before and after the intervention. The collected data were analyzed using paired sample t-test, independent t-test, and Chi-square test.
After the intervention, the levels of stress and anxiety of the patients and their spouses were measured in both groups using independent t-test and a significant difference was observed (P = 0.001). The level of depression of the patients and their spouses was measured in both groups using independent t- test, yet no significant difference was found (P > 0.11).
It is recommended to include sex education in training programs for heart patients in cardiac care units.

One of the important duties of nurses is to protect patients against any injuries. In most cases, physical restraint is applied as one of the immunity tools. In cases that other actions are not possible, physical restraint seems to be one of the acceptable interventions to protect patients or personnel of the unit.
The current study aimed to assess the effectiveness of multifactorial intervention on observance of physical restraint standards of patients hospitalized in intensive care units.
Patients and In this clinical trial study, 240 patients under physical restraint and hospitalized in intensive care units of Hazrat Rasool Akram hospital were studied in two control and intervention groups with convenience sampling. Observance of the physical restraint standards was first recorded with observational checklist. Then, the multifactorial intervention (education through pamphlet, installation of poster in the unit and physical restraint datasheet) was executed for one month. After that, observance of standards was recorded and compared with that of the control group. The collected data were analyzed using SPSS v.16 software with independent t-test and Chi-square test.
The findings showed that observance of physical restraint standards in the control group was undesirable in more than half of the patients (56.7%) and relatively desirable in the intervention group for the majority of the patients (73.3%). Result of independent t-test showed statistically significant difference in observance of standards between the control and intervention groups (P value Considering the obtained results, multifactor intervention increased the observance rate of physical restraint standards for patients hospitalized in intensive care units. As a result, it is suggested to use multifactor intervention (education to personnel, recording restraint and installing poster) to improve immunity of patients and reduce the side effects of physical restraint in intensive care units.

The main problem of preterm infants is lung function disorder and disordered oxygenation due to an immature respiratory tract, therefore, appropriate performance of nurses in oxygen therapy is very important.
The aim of this study was to investigate nurses’ performance during oxygen therapy for hospitalized infants at the neonatal intensive care unit (NICU).
Patients and In this descriptive, cross-sectional study, 110 nurses working at the NICU of teaching hospitals affiliated with the Isfahan University of Medical Sciences were enrolled by the census. Data were gathered from a questionnaire on demographic characteristics and a checklist for observational assessment of nurses’ performance. Data analysis was done with the SPSS 20 software.
Of the nurses, 39.1% had favorable performance. Furthermore, Spearman’s correlation coefficient indicated that age and nurse’s performance were directly and significantly correlated, yet education level and work shift types were not correlated with performance.
Since oxygen is frequently administered at the NICU, holding in-service training courses for improving nurse’s performance and preventing long-term complications due to oxygen administration seem necessary.

Patients experience moderate to high level of anxiety before surgery. Many strategies such as sedative-hypnotic agents are developed to improve anxiety.
The current study aimed to determine the effect of video and images of operating room on patients’ anxiety, before general surgery.
Patients and A clinical trial was performed on 60 patients undergoing general surgery referred to Shahid Beheshti hospital in Kashan, Iran, from 2014 to 2015. By convenient sampling method, sixty patients were selected and randomly allocated into the experimental and control groups. In the experimental group, the video information and images about operating room was played by a laptop for each patient for 30 minutes on the day before surgery and in the morning before surgery. The state anxiety of the two groups was measured after intervention. The control group received verbal information (the usual method in hospitals). Data analysis was conducted using χ² test, independent T-test and paired T-test by SPSS software version 16.
The mean scores of state and trait anxiety before and after intervention are presented in result section. In the experimental group, mean scores of state anxiety decreased from 3.1 ± 43.8 to 2.3 ± 32.4, following the intervention (P = 0.02). However, mean scores did not significantly change in the control group (P = 0.3).
The current study results indicated that the video and images about operating room can reduce anxiety in patients undergoing general surgery.

One of the highly important duties at the intensive care units (ICUs) for maintaining airway and improving ventilation and oxygenation is suctioning; however, it must be done in a way so that, in addition to the mentioned advantages, it can have the least complications for the patient.
The aim of the present study was to compare the effect of two standard and routine suctioning methods on vital signs, arterial blood oxygen saturation and pain level of patients hospitalized at the ICU.
The present quasi-experimental study was conducted during year 2012 on 80 patients under mechanical ventilation hospitalized at ICUs of Zahedan city. Patients were selected purposively and were randomly divided to two groups. In the first group, suctioning was done based on the standard method recommended by the American association for respiratory care (AARC) and in the second group; it was conducted based on routine nursing care. The data was collected by means of Behavioral Pain Scale (BPS) and bedside monitoring of the patients was done before and at one, five, ten and fifteen minutes after suctioning.
The results showed that suctioning based on the routine method leads to more pain and this pain continues for 10 minutes after suctioning and there was a statistically significant difference between the two groups at one and five minutes (P = 0.000, P = 0.000). The vital signs in both groups increased after suctioning and these changes were more in the second group, however, there was no significant difference between the two groups. Also, the level of arterial blood oxygen saturation increased after suctioning in both groups, but these changes were more in group 1 and there was a significant difference between the measurements at one, five, ten and fifteen minutes after suctioning and before suctioning (P = 0.00, P = 0.000, P = 0.000); yet in the second group, no significant difference was observed in none of the times (P > 0.05).
The results of the present study showed that suctioning in the standard method brings about less pain for the patients. It results fewer changes in vital signs and also leads to increased arterial blood oxygen saturation. Thus, it should be included in the work program of the nurses through adequate training.

A 46-year-old man with severe chest pain without a clear medical history of cardiac ischemia was admitted to emergency ward of Ayatollah Madani hospital in Khoy city, Iran. The patient was diagnosed with possible acute coronary syndromes and located in the first level of triage. After early interventions in the emergency ward, he was transferred to the coronary care unit. After half an hour, the patient was suffering from primary ventricular fibrillation. Advanced cardiopulmonary resuscitation (CPR) was started without delay, then the patient survived after three hours of receiving CPR and 55 times of defibrillation shock.