فهرست مطالب

پرستاری داخلی - جراحی - سال هشتم شماره 1 (Feb 2019)
  • سال هشتم شماره 1 (Feb 2019)
  • تاریخ انتشار: 1398/01/25
  • تعداد عناوین: 7
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  • Reyhaneh Khayyati , Nasrin Rezaei , Mansour Shakiba , Ali Navidian * Page 1
    Background
    Promoting adherence to self-care behaviors is crucial in people with heart failure (HF) who also suffer from psychological problems like depression. The purpose of this study was to disclose the effect of cognitive-behavioral education, compared to conventional training, on self-care behaviors in depressed HF patients.
    Methods
    This randomized clinical trial was performed on 80 individuals (40 in the behavioral - cognitive education group and 40 in the conventional education group) with heart failure and depression who had been admitted to the Cardiology Ward of Ali-ibn-Abitaleb and Khatam-al-Anbiya hospitals of Zahedan in 2018. Data were collected using the Beck depression inventory (BDI) and the self-care heart failure index version 6.2 (SCHFI V. 6.2) before and eight weeks after the end of educational interventions. Patients in the control group received the routine educational materials in four sessions, whereas those in the treatment group received the related educational content through cognitive-behavioral therapy technique in five sessions. Data were analyzed in SPSS V. 21 using independent and paired t-tests, chi-square, and covariance analysis.
    Results
    Although the mean score of self-care behaviors in the cognitive-behavioral group and the conventional education group was not significantly different before the intervention, it was significantly higher in the treatment group (65.14 ± 7.01) than in the control group (36.59 ± 8.25) after the intervention.
    Conclusions
    Given the dramatic impact of cognitive-behavioral education on the improvement of self-care behaviors, it is suggested that the principles of this therapy be integrated into common educational programs for depressed patients with heart failure.
    Keywords: Education, Cognitive-Behavioral Therapy, Depression, Self-Care, Heart Failure
  • Mahdi Poornazari , Mostafa Roshanzadeh , Somayeh Mohammadi , Ali Tajabadi , Khadijeh Dehghani *, Sara Parsa Page 2
    Background
    The long-term complications of hemodialysis deteriorate patients’ quality of life and lead to physical and mental discomfort. Physiologically, sports activities can play an important role in reducing these side effects including muscle cramps.
    Objectives
    The aim of this study was, to determine the impact of isotonic exercise on the frequency of muscle cramps.
    Methods
    This clinical trial was carried out on 60 hemodialysis patients admitted to the dialysis units of Shahrekord and Borujen hospitals in 2014. The intervention included an isotonic exercise program that was implemented during 10 sessions of constant cycling (each lasting 10 minutes) immediately before dialysis. The outcome variable was the number of muscle cramps in patients during the hemodialysis session. The data were analyzed in SPSS-16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential tests (independent and paired t-tests).
    Results
    The mean frequency of leg cramps before the intervention was not significantly different between the two groups (P = 0.10). However, it was significantly different between the groups after the intervention (P = 0.001). Moreover, the number of muscle cramps in the experimental group was significantly lower after the intervention than before implementing the program (P = 0.03).
    Conclusions
    The isotonic exercise of constant cycling has a considerable effect on decreasing the number of muscle cramps in hemodialysis patients. Hence, it is suggested that dialysis units provide facilities for constant walking and cycling to accelerate patients’ treatment.
    Keywords: Isotonic Exercise, Muscle Cramp, Hemodialysis, Chronic Renal Failure
  • Fariba Hatami , Hamid Hojjati * Page 3
    Background
    Cancer is one of the common diseases in childhood, the diagnosis of which shocks parents, especially mothers. Meanwhile, parents’ adaptation to the disease reduces complications and problems.
    Objectives
    Therefore, this study was aimed at exploring the impact of Roy adaptation model on care burden in mothers of children under chemotherapy.
    Methods
    This quasi-experimental study was performed on 36 mothers of children under chemotherapy who had referred to the oncology ward of Taleghani Hospital, Gorgan, in 2018. Random sampling was carried out for both control and experimental groups. The experimental group received a training program based on Roy adaptation model during seven sessions over a four-week period. Data were collected using the Caregiver's Burden Scale (CBS) devised by Elmstahl. The results were analyzed in SPSS-18 using independent and paired t tests as well as covariance test at the significance level of P < 0.05.
    Results
    The means of care burden before the intervention in the experimental and control groups were respectively 70.44 ± 7.04 and 67.11 ± 6.54. The independent t test did not reveal any significant difference in this regard (P = 0.15). However, after the intervention, the mean of care burden significantly differed between the experimental (50.94 ± 4.58) and control (70.88 ± 5.13) groups, as confirmed by independent t test (P < 0.001).
    Conclusions
    Based on the results, deploying the care program based on Roy adaptation model is an effective, low-cost, and non-invasive nursing intervention for mothers of children with cancer.
    Keywords: Roy Adaptation Model, Care Burden, Mothers, Children, Chemotherapy
  • Sedigheh Fooladi , Fereshteh Ghaljaei *, Ali Navidian , Ghasem Miri, Aliabad Page 4
    Background
    One of the non-pharmacological methods for relieving pain in children is to deploy cognitive-behavioral interventions such as distraction therapy.
    Objectives
    The aim of the present study was to examine the impact of distraction on physiological indices and the severity of pain caused by intra-spinal injection of chemotherapy drugs in children with cancer.
    Methods
    This was a clinical trial with a pretest-posttest design. The subjects included 89 cancerous children aged 6 - 12 years who had been admitted to the Hematology Ward of Ali Ibn Abitalib Hospital, Zahedan, Iran. The patients were divided into the intervention (n = 45) and control (n = 44) groups. In order to distract the children, they were asked to choose one out of three animated series based on their interest. They received the injection while watching the cartoon. Then, the severity of pain caused by intra-spinal injection of the chemotherapy medication, heart rate, and arterial oxygen saturation (SaO2) were evaluated.
    Results
    Arterial oxygen saturation of the intervention group increased from 95.42 ± 4.53 before distraction to 98.04 ± 2.20 after distraction (P < 0.001). The mean heart rate in the intervention group decreased from 108.64 ± 13.36 before distraction to 104.00 ± 12.25 after distraction, suggesting a significant difference between the two groups (P = 0.04). The mean changes in the heart rate were significantly different between the two groups (P < 0.001). Moreover, the mean pain intensity after distraction was significantly lower in the intervention group (35.11 ± 14.71) than in the control group (42.5 ± 16.44) (P = 0.02).
    Conclusions
    Based on the results, distraction therapy can be effective in mitigating the severity of pain caused by intra-spinal injection and improving hemodynamic indices (heart rate and SaO2).
    Keywords: Pain, Distraction Therapy, Hemodynamic Index, Children, Intra-Spinal Injection
  • Sa’diyeh Aslani , Sepideh Nasrollah *, Tahereh Nasrabadi Page 5
    Background
    Improving the self-efficacy of cardiac patients is one of the pressing necessities that must be considered in the healthcare system. Meeting this urgent need requires comprehensive educational programs.
    Objectives
    Therefore, the present study aimed at exploring the impact of empowerment on the self-efficacy of patients with ischemic heart disease who had been hospitalized in Imam Khomeini Hospital affiliated to Lorestan University of Medical Sciences.
    Methods
    This clinical trial was carried out in 2018 on patients with ischemic heart disease who had referred to Imam Khomeini Hospital in Pol-e Dokhtar, Lorestan province, Iran. A total of 56 patients were randomly chosen and assigned to the control and experimental groups. The standard chronic disease self-efficacy scale (CDSES) was used for data collection. The empowerment program was presented in three 45-minute sessions, and the data were analyzed by SPSS version 23 using covariance, independent t test, and descriptive statistical tests.
    Results
    The results of the independent t test revealed no significant difference in the mean scores of self-efficacy between the two groups before the intervention. However, after the intervention and at the first and second phases of control, the mean score of self-efficacy was higher in the experimental group than in the control group. Moreover, the results of covariance analysis established that while self-efficacy promoted in the experimental group, it did not change in the control group.
    Conclusions
    Empowerment training can promote self-efficacy in patients with ischemic heart disease, which, in turn, can facilitate their treatment process and ultimately enhance the health system efficacy.
    Keywords: Empowerment, Self-Efficacy, Ischemic Heart Disease
  • Masoumehsadat Mortazavinasiri , Shahla Mohammadzadeh Zarankesh *, Mohammad Fesharaki Page 6
    Background
    One of the most fundamental causes of medical errors is the lack of proper communication between the members of the treatment team. The World Health Organization (WHO) has introduced the surgical safety checklist (SSC) for surgical safety to provide a safe environment for patients undergoing surgery, improve communication between surgical team members, and prevent potential medical errors.
    Objectives
    This study evaluated the communication patterns of surgical teams in order to examine the ways to implement various guidelines of the SSC.
    Methods
    In this descriptive cross-sectional study, a trained researcher attended 48 operations from late September to late November 2018. The observer recorded qualitatively the communication behaviors of the surgical team in implementing various items of the SSC. The observations were subsequently examined in two general categories of verbal and non-verbal communications. The surgical procedures were observed at three stages: patient’s admission until entry to the operating room, entry to the operating room until anesthesia induction, and anesthesia induction until patient’s transfer from the operating room.
    Results
    In this study, 31 individuals took part in 48 different surgical teams. Observing the communication patterns revealed the lower frequency of verbal communication (13.27%) than that of non-verbal communication (32.12%). The most frequent failure in verbal communication occurred at the anesthesia induction stage (48.57%) and it was related to operating room equipment (6 out of 35 cases of failure). By contrast, the least frequent failure in verbal communication was associated with patient’s admission until entry to the operating room (17.14%).
    Conclusions
    Various cases of communication failure were seen among surgical team members. It is proposed that appropriate training programs be devised to establish a successful communication environment for the correct use of SSC and further clarification of communication patterns in surgical procedures.
    Keywords: Communication, Surgical Safety Checklist, Operating Room, Surgical Teams
  • Husain Sarbaz , Fatemeh Kiyani *, Asadollah Keikhaei , Salehoddin Bouya Page 7
    Background
    Given that diabetes is the most prevalent cause of end-stage renal disease (ESRD) and that dialysis adequacy is an important factor in the survival of diabetic patients, prognosis of these individuals is predicated according to adequate and standard hemodialysis.
    Objectives
    The present study aimed at investigating the effect of lowering dialysate solution temperature on dialysis adequacy.
    Methods
    This was a clinical trial, in which 32 qualified patients were studied. The subjects were chosen by convenience sampling from patients, who had referred to Ali-Ibn Abitaleb Hospital of Zahedan in spring, 2018. Each patient underwent hemodialysis twice, in which the solution temperature was reduced by one temperature from 37°C to 36°C. Except for the temperature decrease, other conditions were identical during the study. To evaluate the adequacy of dialysis in each session, blood samples of patients were examined before and after dialysis. Data were analyzed in SPSS 21 using descriptive statistics and dependent t-test. The significance level was set below 0.05.
    Results
    The mean and standard deviation of age was equal to 60.2 ± 9.2 (year), duration of diabetes was 12.07 ± 7.25 years, duration of hemodialysis was 27.7 ± 21.8 (months), and weight gain between two sessions of dialysis was 1.6 ± 0.68 (kg). The mean and standard deviation of dialysis adequacy index equaled 1.14 ± 0.34 in the two cold sessions and 0.98 ± 0.20 in the routine session, suggesting significantly higher value in the cold sessions (P < 0.001).
    Conclusions
    Administering cold dialysis solution (36°C) positively influences dialysis adequacy. Therefore, if patients are not medically prohibited from using the cold solution, cold dialysis solution should be prescribed to hemodialysis patients.
    Keywords: Cold Dialysis Solution, Dialysis Adequacy, Diabetic Patients, Hemodialysis, Chronic Renal Failure