فهرست مطالب

Evidence Based Care
Volume:9 Issue: 1, Spring 2019

  • تاریخ انتشار: 1398/01/12
  • تعداد عناوین: 8
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  • Maryam Khajeh, Tahereh Sadeghi *, Monir Ramezani, Raheleh Derafshi Pages 7-15
    Background
    Baby colic is one of the most common digestive problems in infants. Due to its several and unknown causes, colic treatment depends on the parent's individual and social education and support.
    Aim
    This study aimed to determine the effect of mothers' educational supportive care program on the pain intensity and crying caused by colic in infants aged 1-5 months.
    Method
    This study was conducted based on a randomized controlled clinical trial. This study included 88 infants with colic who were referred to a specialized pediatric clinic at a public hospital in eastern Iran. The patients were randomly divided into the intervention and control groups. The educational supportive care program was implemented for eight days and the infant crying duration and frequency were recorded each day. On the other hand, the control group received the clinic routine care. Subsequently, the data were analyzed in SPSS software (Version 21).
    Results
    The two groups were homogeneous in terms of demographic variables (P<0.05). According to the results of the paired t-test, the infant pain intensity in the intervention and control groups was 0.7±1.7 and 0.7±1.7, respectively (P<0.001). Moreover, the duration of the crying caused by colic pain based on the Wilcoxon test was 6.2±22.8 and 6.2±8.9 min in the intervention and control groups, respectively (P<0.001). Implications for Practice: Individual education and provision of an educational supportive care program can affect infants' pain and cry. Therefore, it is suggested that further studies provide a group and peer educational supportive care program.
    Keywords: Educational supportive care program, Infant, Infantile colic
  • Reza Haji Ali Beigloo, Samira Mohajer, Ali Eshraghi, Seyed Reza Mazlom * Pages 16-25
    Background
    Self-efficacy of medication use and pharmaceutical knowledge are important factors for medical treatment completion.
    Aim
    This study aimed to determine the effect of self-administration of medication program on pharmaceutical knowledge and satisfaction of patients with cardiovascular diseases.
    Methods
    This randomized clinical trial was conducted on 60 patients with cardiovascular diseases (CVD) in Imam Reza hospital in Mashhad during 2018. Self-efficacy was examined using the standard scale of self-efficacy for appropriate medication use. Moreover, pharmaceutical knowledge was examined using the standard scale for the measurement of patients’ knowledge level before and after the intervention. Patients’ satisfaction with the medication use manner was also evaluated at the time of discharge from the hospital. Data were analyzed in SPSS software (Version 20).
    Results
    According to the results, the mean ages of patients in the intervention and control groups were 40.9±8.6 and 44.4±8.5, respectively. In the pre-test, the self-efficacy and pharmaceutical knowledge scores obtained from independent t-tests and Mann-Whitney U test were homogeneous. However, self-efficacy scores in the post-test were 32.0±3.3 and 24.7±3.1 in the intervention and control groups, respectively. The mean satisfaction of patients with medication use manner was significantly higher in the intervention than that in the control group (P<0.001). Implications for Practice: The self-administration of medication program in qualified patients with CVD can improve medication use and pharmaceutical knowledge. Therefore, the application of these programs is suggested improving medication compliance.
    Keywords: Patients’ pharmaceutical knowledge, Patients with cardiovascular diseases, Patients’ satisfaction, Self-administration of medication program
  • Nazpari Ashouri, Masoumeh Kordi *, Mohammad Taghi Shakeri, Fatemeh Tara Pages 26-34
    Background
    Postpartum hemorrhage (PPH) is considered as one of the major causes of maternal mortality worldwide. The most effective risk factors have been suggested in various studies on risk nomogram for the prediction of PPH.
    Aim
    This study aimed to determine the diagnostic value of the risk nomogram for the prediction of PPH.
    Method
    This study was performed prospectively using diagnostic methods on 600 women admitted to Omolbanin Hospital, Mashhad, Iran, from May to October 2017. The researcher measured and recorded the loss of blood volume in mothers using plastic blood collection bags and pads within 4 h after delivery. Subsequently, risk nomogram was completed for each study sample and the probability score for PPH was calculated by the researcher’s assistants. The obtained data were analyzed in SPSS software (Version 25). Ultimately, the receiver operating characteristic (ROC) curve of risk nomogram was plotted in this study.
    Results
    The PPH occurred in 33.3% (n=200) of deliveries in this study. The area under the ROC curve was estimated at 81.2%. The point of 0.1 with 85.5% sensitivity and 51.5% specificity was also selected as the proposed cut-off point for this nomogram.
    Implications for practice: According to the results, the risk nomogram was considered as an appropriate method for the prediction of PPH. Therefore, it was recommended as a simple and noninvasive approach in childbirth for the prediction of PPH.
    Keywords: Nomogram, Postpartum Hemorrhage, Risk Factor, Specificity, Sensitivity
  • Mohadese Babaie, Azam Shirinabadi Farahani *, Manijeh Nourian, Asma Pourhoseingholi, Anahita Masoumpour Pages 35-42
    Background
    Catheterization is the most common cause of pain and distress in children, which causes physical and psychological dysfunctions and disrupts the treatment. Therefore, the control of this type of pain should be considered as a priority for nursing care. The audio-visual distraction can be used to reduce the intensity of pain.
    Aim
    The purpose of this study was to determine the effect of audio-visual distraction on catheterization pain among school-age children.
    Methods
    This randomized clinical trial included 64 school-age children assigned into intervention and control group in Qods Hospital during 2016. Oucher face pain intensity scale was utilized to evaluate the intensity level of pain.  Catheterization duration was also recorded in this study. Data were analysed in SPSS software (Version.18) through descriptive statistics, t-test, Mann-Whitney U test, and Spearman correlation analyses.
    Results
    The mean ages of the intervention and control groups were 7.8±1.4 and 7.7±1.6, respectively. The results of the Mann-Whitney U test showed that the mean pain intensity was lower in the intervention group after using the three-dimensional glasses (P=0.01). Spearman correlation test results indicated that there were no significant differences between different ethnicities (P=0.37) and birth ratings (r=-0.061, P-value=0.63) in terms of mean pain intensity.  Implications for Practice: According to the results, the use of distraction methods could  reduce the pain. In addition, they facilitated medical procedures. The role of variables, such as age, gender, and duration of catheterization should be considered in pain intensity.
    Keywords: Audio-visual distraction, Catheterization, Pain, School-age children
  • Abbas Heydari, Ali Meshkin Yazd, Parvaneh Soodmand * Pages 43-51
    Background
    According to the World Health Organization, one in four people experience a psychiatric disorder throughout his/her life. For centuries, psychiatric patients have been sent to psychiatric hospitals that often stigmatized and located out of the community. Moreover, these patients are stigmatized by the hospital staff because they are not aware of patients’ experiences in this domain. This humiliating attitude leads to low self-esteem, isolation, and frustration, and prevents patients from seeking treatment.
    Aim
    This study aimed to explain the lived experiences of patients with psychiatric disorders on the consequences of stigma in mental health centers.
    Methods
    This hermeneutic phenomenological study is a part of a larger study undertaken for partial fulfillment of the requirement for PhD dissertation in nursing. The main study was conducted on 12 psychiatric patients during 2014-2015. They were selected based on purposeful sampling method. Data were collected using unstructured interviews and analyzed by an interpretative method.
    Results
    Psychiatric hospital as an unsafe place is one of the main themes of the phenomenon under study in the original project. It consists of two sub-themes (i.e., an egregious hospital and cold-hearted white collars) each of which is supported by a number of common meanings. Implications for Practice: The results of this study can shape the interventions and policies to combat and prevent the spread of stigma through health centers about people with psychiatric disorders.
    Keywords: Lived experience, mental health centers, Patients with psychiatric disorders, Stigma
  • Yasaman Yazdanpanah, Amir Reza Saleh Moghadam, Seyed Reza Mazlom, Reza Haji Ali Beigloo, Samira Mohajer * Pages 52-62
    Background
    Aging population growth is accompanied by the risk of cardiovascular diseases and hypertension. Medication nonadherence is one of the problems affecting patients, especially elderly individuals with high blood pressure.
    Aim
    The present study aimed to determine the effect of an educational program based on the Health Belief Model (HBM) on medication adherence in older adults suffering from hypertension.
    Methods
    This randomized controlled clinical trial was conducted on 60-year-old elderly people referring to health centers in Mashhad, Iran, during 2017. To this end, the intervention group received education on medication adherence while the control group was only subjected to typical routine services. The data were analyzed in SPSS Software (Version 20) through the independent t-test, Chi-square test, and Fisher’s exact test.
    Results
    The mean ages of the participants in the intervention and control groups were 69.1±8.3 and 63.9±6.7 years, respectively. The post-test mean score of medication adherence obtained by the intervention group was 6.7±0.5 that was significantly higher than that of the control group (3.7±1.0) (P˂0.001). Moreover, the mean score of medication adherence in the intervention group had significantly increased in the post-test phase (P˂0.001) based on the within-group results of the paired t-test. Implications for Practice: The HBM might improve medication adherence in elderly individuals with hypertension by changing their beliefs. Therefore, it was recommended to use this model for teaching self-care to older adults suffering from chronic illnesses and also in other senior healthcare centers.
    Keywords: Education, Elderly, Health belief model, Hypertension, Medication Adherence
  • Sima Saeedi Aval Nooghabi, Maryam Moradi *, Masoumeh Kordi, Masoumeh Mirteimouri, Mohammad Taghi Shakeri Pages 63-68
    Fear of childbirth is an important and prevalent problem during pregnancy and delivery. Self-efficacy of childbirth is one of the factors playing an important role in the fear of delivery. This study aimed to determine the relationship between the fear and self-efficacy of childbirth during labor in primipara women. This descriptive and analytical study was conducted on 100 primipara women in Ommolbanin Hospital, Mashhad, Iran, during 2017. Data were analyzed in SPSS software using descriptive statistics and Pearson’s correlation coefficient. According to the results, the mean scores of fear and self-efficacy of delivery were reported to be 48.9±14.2 and 220.5±54.9, respectively. In addition, there was a reverse association between the scores of fear of childbirth and self-efficacy of delivery using Pearson’s results (r=-0.44, P<0.001). Therefore, it is recommended that interventions be carried out to decrease the fear of childbirth.
    Keywords: Delivery, fear, labor, Self-efficacy
  • Fatemeh Effati, Daryani, Sakineh Mohammad Alizadeh Charandabi, Azam Mohammadi, Somayeh Zarei, Mojgan Mirghafourvand * Pages 69-76

    This study aimed to determine sleep quality and its socio-demographic predictors regarding three trimesters of pregnancy. This cross-sectional study was conducted on 605 pregnant women referred to health centers in Tabriz, Iran, using a two-stage cluster sampling method. Data were collected using socio-demographic characteristics questionnaire and the Pittsburgh Sleep Quality Index. The mean±SD of the total sleep quality scores were estimated at 5.22±2.52, 5.82±3.07, 8.60±3.03, and 6.56±3.24 in the first, second, and third trimester, and during the whole pregnancy, respectively. Moreover, the study results showed that 81 (40.1%), 105 (53.0%), 172 (83.9%), and 358 (59.2%) mothers experienced sleep disorder in the first, second, and third trimester, and during the whole pregnancy, respectively. According to the results of this study, sleep quality predictors may help health providers identify high-risk pregnant women in terms of sleep disorder to provide them with appropriate interventional programs.

    Keywords: Iran, pregnancy, Sleep