فهرست مطالب

پرستاری داخلی - جراحی - سال پنجم شماره 4 (زمستان 1395)
  • سال پنجم شماره 4 (زمستان 1395)
  • تاریخ انتشار: 1395/12/25
  • تعداد عناوین: 8
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  • Sahar Dalvand, Enayatollah Bakhshi, Mozhdeh Zarei, Masoud Taheri Asl, Reza Ghanei Gheshlagh* Pages 1-14
    Background
    Metabolic syndrome is a set of metabolic disorders, including abdominal obesity, hypertension, increased fasting blood sugar, increased serum triglyceride level, and decreased high-density lipoprotein (HDL) cholesterol level. This condition elevates the risk of cardiovascular diseases and diabetes. Regarding this, the present study aimed to evaluate the prevalence of metabolic syndrome in Iran.
    Methods
    This systematic review was conducted on the articles published within 2000-2015. The search was performed using the international databases, including Google Scholar, Science Direct, PubMed, and Scopus, and Persian databases of SID, IranMedex, and MagIran. The keywords employed during the searching process entailed: “Prevalence”, “Frequency”, and “Metabolic syndrome”. The heterogeneity between the studies was assessed using I2 index. Data analysis was performed through meta-analysis technique (random-effects model) in Stata version 12.
    Results
    In the 32 studies conducted in Iran with the sample size of 74,440 cases, the total prevalence of metabolic syndrome was reported to be 32% (95% CI: 28-35). Based on the National Cholesterol Education Program/Adult Treatment Panel III, International Diabetes Federation, and Joint Interim Statement criteria, the prevalence rates of metabolic syndrome were reported to be 30% (95% CI: 25-34), 34% (95% CI: 29-40), and 39% (95% CI: 33-45) in 23, 13, and 5 studies, respectively.
    Conclusion
    As this study indicated, metabolic syndrome has a high prevalence in Iran. However, no significant changes have been observed in the prevalence of metabolic syndrome in the past few years in this country. Therefore, the high prevalence of metabolic syndrome can be prevented by focusing on the reduction of risk factors for this disorder.
    Keywords: Iran, Meta-analysis, Metabolic syndrome, Prevalence, Systematic review
  • Vahideh Karimi, Nasrin Hanifi*, Nasrin Bahraminejad, Soghrat Faghihzadeh Pages 15-21
    Background
    Hospitalization in cardiac care unit (CCU) results in much anxiety followed by changes in hemodynamic indices in most patients. The accompanying family members play an important role in patient’s care and support. Therefore, the current study was performed to determine the impact of family-based training programs on hemodynamic indices and duration of hospitalization for patients with coronary artery disease.
    Methods
    The population of this clinical trial study consists of patients with coronary artery disease hospitalized in CCU of an educational hospital in Zanjan, Iran in 2013. Eighty patients were selected through convenience sampling method, and were randomly assigned into the two groups of intervention and control. The family-based training program for the intervention group was executed as three 40-60 min sessions of face-to-face meeting with the patients and the core accompanying family member. Mean hemodynamic indices of the patients including systolic and diastolic blood pressures, average arterial blood pressure, and heart rate were measured and recorded on days one to four of the hospitalization based on the hospitalization duration. Data analysis was performed by Chi-square, independent t-test, and repeated measures ANOVA.
    Results
    Post-intervention, the hemodynamic indices and hospitalization duration were lower in the intervention group compared to the controls. However, this difference was significant for heart rate (P
    Conclusion
    Family-based training programs are recommended as a cost-benefit method in CCU.
    Keywords: Family-based nursing, Hemodynamics, Hospitalization duration, Patients education
  • Tooran Bagheri, Mohammad Javad Fatemi*, Seyed Abouzar Hosseini, Mohsen Saberi, Mitra Niazi, Mahnoush Momeni, Zahra Masoumi Pages 22-30
    Background
    Burn is among the problems, which leads to numerous health and financial side effects for the patients and their families. The high costs of new dressings and burn rehabilitation have resulted in the increased tendency of researchers toward using complementary therapies and cost-effective ingredients such as honey with natural origin. Regarding this, the aim of this study was to compare the effect of topical use of honey and Nitrofurazone ointment on superficial second-degree burn healing.
    Methods
    This clinical trial was conducted on 50 patients with superficial second-degree burns referring to Yaftabad Hospital, Tehran, Iran, during 2013-2015. The participants were selected using the convenience sampling method, and then randomly assigned into two groups. The wounds were dressed daily until complete wound healing, with organic honey in one group and Nitrofurazone ointment and sterile gauze in the other group. For the purpose of the study, the two groups were compared in terms of such factors as pain intensity (for the first week), antibacterial activity (for the first week), histopathological parameters (14 days later), wound healing, and wound scar (6-12 months later). The comparisons were made through the visual analogue scale, laboratory culture results, pathologist’s ratings, daily photographs, and Vancouver Scar Scale, respectively. The data were analyzed using the SPSS software version 21 by the t-test and Chi-square test.
    Results
    According to the results, the patients’ pain intensity gradually decreased in both groups of honey (P0.05). Furthermore, the two groups showed no significant differences in terms of the epithelialization rate (P=0.52), inflammatory cells (P=0.71), vascularization (P=0.79), repair duration (P=0.43), and scar score (P=0.28).
    Conclusion
    As the findings of the present study indicated, honey and Nitrofurazoneon had comparable effects on the healing of second-degree burns (i.e., partial thickness) with less extended area. However, further studies are needed for the replacement of Nitrofurazone with honey.
    Keywords: Honey, Nitrofurazone, Second-degree burn
  • Fariba Yaghoubinia, Seyed Mohammad Nasir Al Din Tabatabaei, Mojgan Jahantigh, Parastoo Mohammadi* Pages 31-37
    Background

    Ventilator-associated pneumonia (VAP) is one of the common problems in patients who are under mechanical ventilation and increases the hospitalization duration and treatment expenses. The current study was conducted to determine the impact of a care program on VAP.

    Methods

    This clinical trial was performed on intubated patients who were under mechanical ventilation in Intensive Care Unit (ICU) of teaching hospitals in Zahedan, Iran in 2015. Seventy patients were selected through convenience method and were assigned into two groups of 35 people as the control and intervention groups. The care program was executed for three days in the intervention group. Pneumonia incidence was evaluated by the Modified Clinical Pulmonary Infection Score (MCPIS) both pre- and post-intervention. The data were analyzed by independent t-test and Chi-square test.

    Results

    Pneumonia did not occur in the intervention group, while VAP occurred in 54% of the patients of the control group. The Chi-square test demonstrated a significant difference between the two groups (P

    Conclusion

    Preventive interventions might be beneficial in reducing the occurrence of VAP when executed as a regular caring package for the patients. Therefore, these therapies are recommended as a nursing intervention in ICUs.

    Keywords: Care program, Intubation, Intensive Care Unit, Ventilator-associated pneumonia
  • Hamed Sarani, Ali Navidian, Somayeh Jahani, Ebrahim Ebrahimi Tabas, Soleiman Bidar* Pages 38-44
    Background
    Chlorhexidine is a common and safe antibacterial agent applied for hand hygiene and skin decontamination. Given the fact that the majority of nosocomial infections are observed in the special units of hospitals, this study aimed to assess the effect of daily chlorhexidine bath on skin colonization of the patients in the Intensive Care Unit (ICU).
    Methods
    This quasi-experimental study was conducted on 80 patients admitted to ICU of a teaching hospital affiliated to Zahedan University of Medical Sciences, Iran, in 2016. Patients were selected through convenience sampling and were non-randomly divided into the two groups of intervention and control, each of which consisting of 40 individuals. Patients of the intervention group were bathed with a sponge soaked with chlorhexidine 2% solution daily for five days, whereas subjects of the control group received no particular skin bath or disinfecting intervention.
    Results
    The positive results of the first culture were not significantly different (P=0.63). However, 100% of the control subjects and 7.5% of the participants in the intervention group had positive results in the second culture. Fisher’s exact test indicated that the difference between the two groups was significant in this regard (P
    Conclusion
    Given the reducing effect of bathing with chlorhexidine 2% on skin colonization and superficial skin infections, this method could be recommended as an approach for decreasing the risk of nosocomial infections in patients admitted to ICUs. However, further studies are suggested to evaluate these effects more precisely.
    Keywords: Bath, Chlorhexidine, Intensive care unit, Skin colonization
  • Seyedeh Toktam Masoumian Hoseini, Zahra Sadaat Manzari, Ali Bazzi* Pages 45-51
    Background
    Inadequate self-care and knowledge about diabetes are important causes of chronic complications among diabetic patients. This study aimed to evaluate the effect of a participatory care program on self-care and disease awareness in these patients.
    Methods
    This quasi-experimental study was conducted on 90 diabetic patients referred to Parsian Diabetes Clinic in Mashhad, Iran, 2015. The patients were selected through convenience sampling and randomly assigned to intervention and control (n=45 for each group) groups. The participatory care program entailing four stages of motivation, preparation, involvement, and evaluation was performed for the intervention group through seven 60-90 minute sessions. Data was collected using Diabetes Knowledge scale and Summary of Diabetes Self-Care Activities (SDSCA) questionnaire, which were completed based on interviews with patients before and three months after the intervention. To analyze the data, descriptive statistics, Fisher’s exact test, Chi-square, independent and paired t-tests, as well as Pearson’s correlation coefficient were used in SPSS, version 20.
    Results
    After performing the participatory care program on the intervention group, the mean scores of disease awareness and self-care significantly increased from 48.0±12.7 to 91.5±7.6 and from 23.5±15.7 to 52.3±13.2, respectively (P
    Conclusion
    Given the effect of participatory care program on the improvement of knowledge and self-care in patients with diabetes or other chronic diseases, it is recommended to perform this procedure as a customized method based on Iranian culture.
    Keywords: Diabetes, Knowledge, Participatory care, Self-care
  • Mohammad Ali Cheraghi, Akram Sadat Hoseini, Roya Gholami, Imaneh Bagheri, Nilofar Binaee, Pegah Matory* Pages 52-53
    Background
    Recently, the "Disruptions in the Energy Field" have been omitted from the list of nursing diagnoses published by the North American Nursing Diagnosis Association (NANDA). Therapeutic touch is a scientific nursing intervention. The aim of this study was to identify the efficacy of therapeutic touch (TT) and investigate the tenability of omitting this diagnosis from the NANDA nursing diagnosis list.
    Materials And Methods
    In this systematic review, we employed the English and Persian articles in complementary therapy(Therapeutic Touch) area published within January, 2006-December, 2016. The articles were obtained by searching such databases as the Proquest, PubMed, Science Direct, SID, Magiran, and Iran Medex. The searches were performed using the following keywords and their MeSH equivalents: “Therapeutic Touch", "Aura Therapy", and "Energy Healing". Finally, 13 articles were selected based on the inclusion criteria. The articles were evaluated based on a standard checklist presented by the Cochrane database. The articles were presented based on PRISMA format.
    Results
    Out of the 3 review articles and 736 research articles, which were retrieved, 13 studies were examined in full-text with especial focus on the quality of methodology sections.
    Conclusion
    Based on the reviewed articles, that observing no significant impact following TT interventions does not mean that this approach is actually ineffective. It may just be due to inappropriate methodology and research design employed for investigation. Therefore, we need to focus on the methodologies of these randomized control trials rather than their final results.
    Keywords: Rogers, Systematic review, Therapeutic touch
  • Pages 54-60
    Background And Objective
    Comfort and convenience to patients as a basic need, especially before major surgery which is performed according to those in nursing is very important. This study aimed to determine of Effect of Benson relaxation technique on comfort rate in patients before CABG referred to the BuAli Hosptal of Ghazvin city in 2016.
    Materials And Method
    This study is Quasi-experimental study that in that Pretest-posttest plan with control group was used. All of the Patients undergoing the CABG, who referred to the BuAli Hosptal of Ghazvin city in first 6 months of 1395, were our statistical research community. 64 patients were selected Based on inclusion criteria and purposive sampling method and randomly divided into two groups of experimental and control by using a table of random numbers. For relaxation intervention groups for two sessions of practice on the evening before and the morning of surgery for every 30 minutes was conducted by phone. Patient filled 8. Kolcaba comfort questionnaire before and after intervention. SPSS statistical software SPSS19 data using chi-square, Fisher''s exact test, and independent t-test and paired T was performed.
    Results
    Results showed that no different between two groups of intervention and control about demographic characteristics. The mean comfort Score was 57/37±7/71 in intervention group, and 54/9±4/31 in the control group before intervention, which respectively reached to 35/96±8/84 and 53/43±3/65 after implementation of the intervention and this difference was Significant in intervention group (p≤0/001).
    Conclusion
    According to the results we can say that Benson relaxation in increasing the comfort level of patients before coronary artery bypass surgery is effective. So the method used in this study as a simple, non-invasive, low-cost and effective in increasing the convenience to nursing.
    Keywords: Benson relaxation, comfort, CABG