نشریه پرستاری مراقبت ویژه
سال یازدهم شماره 4 (پیاپی 40، زمستان 1397)

  Happiness is considered to be one of the basic excitements and thrills of human beings. Happiness actually leads to a positive attitude towards life, positive self-concept, mental health and emotional balance, better educational and job performance, and as a results, better decision-making. The aim of this study was to determine the amount of happiness in nurses working in the emergency department of the hospitals of Ilam University of Medical Sciences. This study was an analytical descriptive research. The population included 225 nurses working in the emergency department of the hospitals of Ilam University of Medical Sciences in 2019 which were selected by census method. Data was collected using the Demographic Information Questionnaire and Oxford Happiness Questionnaire. Data was analyzed using spss-24 and by Pearson correlation, Anova and t-test. The average age of the participants was 30.44 ±6.64 and the average work experience6 was 6.49±6.19. The mean of happiness in nurses was 67.43± 17.28. The statistical relationship between age and happiness was significantly negative (P= ‒0.333). There were significant relationships between happiness and gender, degree of education, marital status, employment status and monthly earnings. This is while no significant relationship was observed between happiness, enough money and shift schedules. The highest scores were obtained in the dimension of self-concept with an average of 18.23 ± 4.98 and the lowest score was seen in the dimension of gusto with an average of 4.56 ± 1.66. According to the findings of the present study it can be concluded that happiness has been reported in a good level within most nurses. Moreover, other studies can be conducted to investigate the factors causing happiness in order to facilitate the development of happiness.

Among all the different types of cardiovascular diseases, the angina pectoris disease has been considered to be the most prevalent. In order to promote the health status of those who are struggling with this disease, different factors such as self-efficacy can be considered. However, the results of previous research in regards to the factors of self-efficacy of angina pectoris patients is extremely diverse. The aim of the present study was to determine the level of self-efficacy and its related factors in patients with angina pectoris disease referring to the selected hospitals of Tehran in 2018. This cross-sectional descriptive-analytic study was performed on 270 patients with angina pectoris disease referring to the selected hospitals in Tehran who were selected using the convenient sampling method. Data collection was conducted through an interview using a two-part questioner: demographic information and self-efficacy Sullivan scale in patients with angina pectoris. The statistical analysis of data using descriptive and analytical statistics was performed in SPSS software version 20. The range of self-efficacy score in patients was 0 to 52 with a mean score of 31.07±17.7. Therefore, 39% of patients had a moderate level of self-efficacy. The highest score was related to the dimension of “maintain function” (11.54±3.85) and the lowest score was related to the “control symptoms”(9.57±3.35). The results of the chi-square test revealed no significant relationship between age, sex, marital status, situation, with level of self-efficacy. This is while it showed a significant relationship between education level (P= 0.001), employment status (P= 0.001), economic situation (P= 0.007), duration of having the disease (P= 0.02), kind of disease (P= 0.009), with the level of self-efficacy in patients with angina pectoris disease. Considering the fact that patients with angina pectoris disease did not have high levels of self-efficacy, it is recommended that the factors affecting self-efficacy in the examined patients be further investigated. Finally, necessary steps should be taken in order to deal with these factors.

Fatigue is one of the most common complications in hemodialysis patients, which affects their physical, psychological, emotional and cognitive status. The aim of this study was to investigate the effect of tele-nursing on fatigue in the elderly undergoing hemodialysis. This quasi-experimental study was performed on 60 elderly patients undergoing hemodialysis. Samples were firstly selected by available sampling method according to sample characteristics and were then randomly divided into two groups of test and control. The data were collected by Fatigue Questionnaire in two stages before and after the intervention. Data were analyzed by SPSS software version 24 using descriptive and analytical statistical tests. The mean age of participants was 73.43 ± 7.87 years. According to the findings, 76.7% of the control group and 70% of the test group had severe fatigue before intervention. This amount reached 43.3% in the control group and zero in the test group after the intervention. The mean of the fatigue score before the intervention in the test and control group was 7.39 ± 0.96 and 7.64 ± 1.79, respectively. After the intervention was carried this score changed to 3.15 ± 1.26 and 6.25 ±1.25. Based on t-test, there was a significant difference between the mean of fatigue scores in the elderly patients undergoing hemodialysis before and after the intervention in the test and control groups (p<0/05). Tele- nursing has been effective in reducing the amount and severity of fatigue in the elderly undergoing hemodialysis. Therefore, it is recommended that nurses use this method as a non-drug intervention to reduce fatigue in the elderly undergoing hemodialysis.

One of the most important problems of patients admitted to intensive care units (ICU) is their sleep quality. In these units, there are various visual and auditory discomfort factors that can negatively affect the outcome of the patient's treatment. The purpose of this study was to determine the effect of simultaneously using earplug and eye mask on the quality of sleep in hospitalized patients in the ICU. This study was performed on 73 patients who had been admitted to the ICU of Ghaem Hospital and Imam Reza Hospital in 2016 in Mashhad. Patients were randomly assigned to control (n = 37) and test (n = 36) groups. The test group used an earplug and an eye mask during their night's sleep. Patients' sleep quality was assessed by using Voran-Schneider-Halper's questionnaire. Data were analyzed using SPSS16 software. Independent t-test and Mann whitney U showed that before and after the intervention stage, no significant difference was observed between the test and control groups regarding the mean score of sleep quality. However, the results of Wilcoxon test showed a significant difference in the quality of sleep score in both groups before and after intervention (p <0.001). In this study, simultaneous use of earplug and eye mask was effective in improving the quality of sleep in patients admitted to the ICU. Therefore, this technique can be used as a simple, low-cost, and effective method in helping patients to prevent complications from sleep disorders.

Considering the importance and necessity of neonatal resuscitation training, one of the introduced methods is Educare. The Educare consists of six sections for learning skills. By using this method, the need and necessity of learning, behavioral and particular goals, practical training, supervisions, using the reminder tool, the opportunity to practice and repeat practically, and evaluating skills can be explained. Therefore, this study has aimed to investigate the effectiveness of neonatal cardiopulmonary resuscitation training by Educare method on nurses and midwives' knowledge and performance. The present study was a quasi-experiment research without a control group. It was carried out on thirty nurses and midwives of the Neonatal Intensive Care Units (NICU) and labor and maternity wards who were selected based on convenience and purpose-based sampling in Baqiyatallah Hospital in 2018. The training was carried out by conducting a two-day neonatal resuscitation workshop. The effectiveness of neonatal resuscitation training was tested in three stages of before, immediately after and two months after training by using a researcher made questionnaire and checklist after validity and reliability confirmation. The data was analyzed using descriptive statistics, paired t-test and repeated measures variance analysis by spss25 software. The mean and standard deviation of knowledge and performance scores were 51.93 (SD=6/6) and -129/14(SD=34/97) before and after training, respectively. The mean and standard deviation of knowledge and performance scores were 64/53 (SD=2/36) and-25/7(SD=19/01) immediately after training respectively. Also, the mean and standard deviation of knowledge and performance scores were 59.73(SD=3/42) and -68/7(SD=28/2) two weeks after training, respectively. Findings reveal that there is a significant difference between the mean and standard deviation of knowledge and performance scores before and immediately after and two months after training (p <0.05). Knowledge and performance scores immediately increased after training compared to pre training and also two months after training. To conclude, it can be stated that the Educare method was effective on the level of knowledge and performance of nurses and midwives. Findings also showed that resuscitation training is extremely necessary both at regular intervals and continuously. Therefore, it is recommended that authorities and educational managers use this new method to improve the level of clinical staff’ knowledge and performance related to the neonatal at regular intervals.

Hoarseness and coughing are common complications following endotracheal extubation. It has been stated that humidifier therapy has anti-inflammatory properties. Therefore, the present study has been conducted in order to determine the effect of humidifier therapy on hoarseness and coughing following endotracheal extubation in the elderly undergoing coronary artery bypass surgery. In a clinical trial, 80 elderly patients undergoing coronary artery bypass surgery were selected using convenience sampling. They were randomly divided into two control and experimental groups. The elderly patients in the experimental group were exposed to humidifier therapy after tracheal extubation. The control group received routine care. The intensity of cough and hoarseness were measured in both groups, after tracheal extubation. The severity of cough and hoarseness were recorded in both groups immediately after intervention, 6, 12, 18, and 24 hours after extubation. For analyzing the data, U Mann Whitney, chi-squared and independent t-tests were performed using SPSS version 21. The effect of reducing the severity of coughing by humidifier therapy is -0.51% (P=0.001). Actually, humidifier therapy can reduce the probability of not coughing by 0.6% (P=0.001). Also, the effect of reducing hoarseness with humidifier therapy is -0.51%. Humidifier therapy can reduce the possibility of not hoarsening by 0.5%. The findings of the present study reveal that humidifier therapy can decrease cough and hoarseness in the elderly patients after Endotracheal Extubation.

The subjective workload is a significant stressor in nursing profession and the stress can lead to cognitive problems and occupational cognitive failure. However, the relationship between subjective workload and cognitive failure is ambigious. Therefore, this study was conducted to determine the relationship between nurses’ Subjective workload and occupational cognitive failure in intensive care units. This analytical cross-sectional research was conducted on 176 nurses working in intensive care units of Rasht medical centers in 2017. Samples were selected using census method. The data collection tools consisted of personal and occupational data, standard questionnaires for subjective workload (NASA-TLX) and occupational cognitive failure (OCFQ). The data analysis was performed by the software of SPSS 21 and descriptive and inferential statistic tests of Mann-Whitney and Kruskal-Wallis, Spearman correlation. The majority of samples were female (93.2%) with a mean age of 35.85 ± 7.8, married (71%) and undergraduate (92.2%), ICU (71%), Formal employment (64.2%) with an average work record of 12.21 ± 7. 06 years (86.9%). Mean score and standard deviation for subjective workload was 59.95 ± 16.41 and for occupational cognitive failure 70.31 ± 17.06. There was a significant positive correlation between occupational cognitive failure and subjective workload (r = 0.272, p <0.001). Considering the relationship between subjective workload and cognitive failure, the patient's safety and eventually the quality of care may be improved by designing strategies to reduce the subjective workload and considering its related factors in the planning of human resources employed in intensive care units.