فهرست مطالب

Evidence Based Care - Volume:9 Issue: 2, Summer 2019

Evidence Based Care
Volume:9 Issue: 2, Summer 2019

  • تاریخ انتشار: 1398/04/10
  • تعداد عناوین: 8
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  • Azin Niazi, Maryam Moradi * Pages 7-16
    Background
    It is widely accepted that lower levels of sexual satisfaction and function are among the common problems in postmenopausal women. Several studies have examined the effect of plants containing phytoestrogens for the prevention and treatment of menopause complications.
    Aim
    The main purpose of this study was to investigate the effect of medicinal plants on the sexual satisfaction and function of postmenopausal women.
    Method
    Related English and Persian articles published between 2000 and December 2018 were searched through the databases of Iran Medex, PubMed, EMBASE, Scopus, and Science Direct. The articles were searched using the keyword of "menopause" through Boolean Operators of AND and OR with keywords of "sexual satisfaction", "sexual function", "herbal supplement", "Review Study in English and Persian ".
    Results
    Of the 87 searched articles, 20 articles were ultimately analyzed with a sample size of 1555 people. Plants of Bindii, Fenugreek, Fennel, Liquorice, Pueraria Mirifica, Ginseng, Red clover, and Aphrodit had positive effects on dyspareunia, as well as sexual satisfaction and function. Date pollen did not affect sexual satisfaction; moreover, Ginkgo biloba capsule had no effect on dyspareunia and sexual satisfaction.
    Implications for Practice
    Medicinal herbs containing phytoestrogens can be considered as a selective treatment for the improvement of dyspareunia and enhancement of the sexual satisfaction and function of postmenopausal women. However, due to the variety of herbs containing phytoestrogens, further studies are needed to determine the effective dose and effects as well as their possible complications.
    Keywords: Herbal Supplement, Menopause, Review Study, Sexual function, Sexual satisfaction
  • Fathimath Shifaza, Mohammad Hamiduzzaman * Pages 17-30
    Background
    There is growing attention to evidence-based practice in Australian clinical contexts and nursing literature. Recent research explores the dimensions of evidence-based practice; however, the implementation of evidence-based clinical decision making has been identified as a cumbersome process.
    Aim
    This study aimed to review the literature systematically regarding the system factors and their possible impacts on the process of evidence-based practice implementation.
    Method
    Anelectronic search on major databases, including MEDLINE, PsycINFO, PubMed, ProQuest, Google Scholar, and CINAHL was conducted from January 2018 to March 2018. A rigorous selection process focusing on the inclusion of nurses in the study population and the system factors related to their practices resulted in the selection of 18 articles. Data were extracted from the studies and grouped into categories using a thematic analysis.
    Results
    The factors affecting the nurses' evidence-based practice were identified at the individual, team, and organizational culture levels. The individual domain included a lack of education and clinical expertise, inadequate research skills, time constraint, and low levels of confidence and autonomy in changing practices. The factors identified at the team level associated with a lack of research orientation and peer support. At the organizational culture level, poor research culture and infrastructure were identified as important factors.
    Implications for Practice
    The findings of the system factors would help policymakers to redefine the nursing practice. Moreover, the results raise the nurse's awareness about the importance of using evidence-based practice in decision making.
    Keywords: clinical decisions, Evidence-based practice, health system factors, Nurses
  • Zahra Rajabzadeh Malayjerdy, Seyed Reza Mazlom, Javad Malekzadeh * Pages 31-37
    Background
    Hemodialysis patients experience pains induced by cannulation of an arteriovenous (AV) fistula. The effect of mirror therapy on patients’ pain severity has not been investigated in individuals living with hemodialysis.
    Aim
    The purpose of the present study was to investigate the effect of mirror therapy on AV fistula cannulation-related pain severity in hemodialysis patients.
    Method
    This study was conducted on 30 hemodialysis patients admitted to two hospitals in Mashhad, Iran, during 2018. Pain severity was measured using the Visual Analogue Scale for pain.
    Results
    The mean pain scores in the control session (pre-intervention phase), non-adaptive phase (immediately after looking in the mirror), and adaptive phase (ten minutes after looking in the mirror) were 4.8±1.1, 3.9±1.1, and 2.6±1.22, respectively. The results showed a statistically significant difference between the given sessions (P<0.001).
    Implications for Practice
    Mirror therapy could be effective in reducing AV fistula cannulation-related pain severity in hemodialysis patients.
    Keywords: Arteriovenous fistula, hemodialysis, Pain
  • Marzieh Hassanshahi Raviz, Raheleh Babazadeh *, Kolsoom Akbarnataj Bisheh, Habibollah Esmaily Pages 38-43
    Lower levels of sexual self-efficacy increase high-risk sexual behaviors in prostitutes. In this respect, an educational intervention program based on the Information-Motivation-Behavioral Skills (IMB) model can enhance sexual self-efficacy. Therefore, this study investigated the effects of IMB education on sexual self-efficacy in women. To this end, a clinical trial was conducted on women with high-risk sexual behaviors in Mashhad, Iran (n=84). The study instrument included a questionnaire containing IMB constructs and sexual self-efficacy. The data were analyzed in SPSS software (version 25). There was no significant difference between the groups regarding the mean±SD of sexual self-efficacy before the intervention. However, Friedman test results showed a significant difference between the given phases (P<0.001); however, intra-group comparison results were not significant in the control group (P=0.56). It was recommended to utilize this educational intervention program to increase levels of sexual self-efficacy among women.
    Keywords: Information, Motivation, Self-efficacy, Sexually Transmitted Diseases
  • Fatemeh Farazian, Zahra Emami Moghadam *, Fatemeh Heshmati Nabavi, Hamidreza Behnam Vashani Pages 44-52
    Background
    Self-care in patients with hypertension can be improved through education and implementation of learning theories.
    Aim
    The present study aimed to determine the effect of educating self-care in patients with hypertension through the implementation of Bandura’s self-efficacy model.
    Method
    A randomized controlled clinical trial was conducted on 60 patients with hypertension who visited a randomly selected group of health centers in Mashhad, Iran, during 2017. The intervention group participated in a self-efficacy training program designed based on the self-efficacy theory in the form of four 45-minute weekly sessions. The control group received the routine treatment provided by community health centers. Self-care was measured with the questionnaire of self-care in patients with hypertension at three stages of before the intervention, immediately after the intervention, and one month later. Data were analyzed in SPSS (version 16) software using repeated measures ANOVA.
    Results
    The mean ages were reported at 62.0±6.9 and 59.3±9.2 in the intervention and control groups, respectively. The repeated measures ANOVA showed significant differences between the two groups after the intervention in terms of adherence to medication regimen (P=0.004), engagement in physical activity (P=0.002), adherence to weight management goals (P=0.006). Significant differences were observed between the two groups in terms of their total self-care score immediately after the intervention and one month later (P=0.002).
    Implications for Practice
    The use of Bandura’s self-efficacy theory can improve the self-care in patients with hypertension. Therefore, it is recommended to conduct further studies to examine the long-term effects of training programs based on this theory on the self-care behaviors of patients with hypertension.
    Keywords: blood pressure, Clinical trial, self-care, Self-efficacy
  • Atefeh Eshghi Motlagh, Raheleh Babazadeh *, Farideh Akhlaghi, Habibolah Esmaily Pages 53-64
    Background
    Sense of self-efficacy prepares an appropriate framework for self-care behaviors.
    Aim
    This study aimed at investigating the effect of an educational intervention program based on Bandura’s Self-Efficacy Theory (SET) on self-care, self-efficacy, and blood sugar levels in mothers with pre-diabetes during pregnancy.
    Method
    This randomized two-group clinical trial was conducted on 100 pregnant women with pre-diabetes in Shirvan, Iran, during 2018. The intervention group received educational training according to the constructs of Bandura’s SET. On the other hand, the control group was provided with routine care. The data were collected using Diabetes Self-Care Activities and the standardized and adjusted Diabetes Self-Efficacy Questionnaires, as well as an automatic biochemistry analyzer, and a blood glucose monitoring device. The data were analyzed in SPSS software (version 22) through paired sample t-test, Mann-Whitney U test, and Wilcoxon signed-rank test.
    Results
    The mean ages of the participants in the intervention and control groups were 28.9±7.1 and 29.3±6.2 years, respectively. According to the Mann-Whitney U test results, the intervention group obtained higher scores regarding self-care behaviors and sense of self-efficacy (41.8±13.5, 99.3±16.2), compared to the control group (22.8±5.0, 99.3±16.2, P˂0.001). The mean fasting blood sugar level in the intervention group (75.8±6.7) was significantly lower than that in the control group (85.4±9.7, P˂0.001).
    Implications for Practice
    The promotion of self-care behaviors and self-efficacy strategies in mothers with pre-diabetes during pregnancy could prevent gestational diabetes and reduce the severity of its complications.
    Keywords: Blood sugar level, Pre-diabetes self-efficacy, Pregnant Women, self-care
  • Nahid Pilevar, Monir Ramezani*, Abdolreza Malek, Hamidreza Behnam Vashani Pages 65-73
    Background

    Rheumatoid arthritis is the most prevalent chronic rheumatologic disease of children. The quality of life (QOL) in these individuals is affected by physical pain, discomfort, treatment complications, and frequent absences from school leading to academic failure. No research similar to the present investigation was performed in this area.

    Aim

    We aimed to evaluate the problems of children with rheumatoid arthritis. Moreover, we assessed the effect of family-centered empowerment on the QOL of these children.

    Method

    This randomized clinical trial was performed on 60 children aged 8-12 years diagnosed with rheumatoid arthritis in Akbar Pediatrics Hospital, Mashhad, Iran in 2018. The subjects were divided into test and control groups. The four stages of family-centered empowerment model, namely improvement of knowledge, self-efficacy, self-esteem, and assessment were executed for the test group. After a month, the inventory of pediatric quality of life was completed again. Data analysis was performed by Mann-Whitney U test, independent t-test, and paired t-test using SPSS version 16.

    Results

    No significant difference was observed between the groups regarding age (P=0.351). In addition, the post-intervention QOL of the test group was significantly higher than the control group (P=0.004). There was a significant difference between the pre- and post-intervention QOL in the test group (P < 0.001). Implications for Practice: This study indicated the effect of family-centered empowerment model on the physical, emotional, educational, and social dimensions of QOL of children aged 8-12 years diagnosed with rheumatoid arthritis. As a result, this model is recommended to empower the children with this disease or other chronic diseases and their caregivers.

    Keywords: Child, Family-centered nursing, Quality of life, Rheumatoid arthritis
  • Ebrahim Rafeezadeh, Nosrat Ghaemi, Hamid Heidarian Miri, Aramesh Rezaeian* Pages 74-83
    Background

    Type 1 diabetes is known as the most common endocrine disorder in children which requires strict adherence to self-care regimen. Accordingly, children’s exposure to educational video games can be a strategy for promoting adherence to such regimens.

    Aim

    The main purpose of this study was to investigate the effect of an educational video game for diabetes self-management on adherence to self-care regimens in children with type 1 diabetes.

    Method

    This two-group randomized clinical trial was conducted on 68 children aged 8-12 years affected with type 1 diabetes and admitted to Akbar Children’s Hospital in Mashhad, Iran, during 2018. A self-care package for children with type 1 diabetes was extracted using a review method. The intervention group played the designed interactive video game. Data were analyzed in SPSS software (version 16) through independent t-test and Mann Whitney U test.

    Results

    Both study groups were homogeneous in terms of demographic characteristics. Based on the results of independent t-test, no significant difference was observed between the intervention (77.5±10.1) and control groups (78.7±7.4) regarding mean self-care scores before intervention (P=0.57). However, mean self-care score in the intervention group (82.9±7.8) was significantly higher than that in control group (77.3±7.7) after the intervention (P=0.57). Intra-group comparisons also confirmed the above-mentioned findings.
    Implications for Practice: The designed educational video game could significantly improve children’s self-care scores. Given that Internet-based video games can be manipulated and quickly updated, it was suggested to compare online and offline video games in future studies.

    Keywords: Children, Diabetes, self-care, Video Games