نشریه پرستاری مراقبت ویژه
سال دوازدهم شماره 3 (پیاپی 43، پاییز 1398)

The concept of human dignity has always been at the center of attention of scholars and philosophers throughout the history of human life. This concept has been emphasized in all religions and in fact, has been the endeavor of all religious leaders to defend and preserve the inherent dignity of man. The preservation of human dignity is one of the basic principles of human rights. The World Health Organization (WHO), in its 1994 declaration, considered the importance of dignity to be an important factor in improving the health of patients and considered the right to give an informed consent, access to health services, the confidentiality of information, and privacy as important (1(.
The concept of human dignity has always been considered in the nursing profession. Thus, the essence and essential nature of nursing care is to protect the patient's human dignity (2).
 
This concept has been first emphasized in the Nurses Ethical Charter by the American Nurses Association (2001) and in the Nursing Ethics Code of the Islamic Republic of Iran (2011) as one of the fundamental values ​​of the nursing profession. So that "all human beings have high human dignity and must be respected. Therefore, all patients should be respected by health care workers, regardless of their social, economic, and cultural status (3, 4). Despite recent attention to the concept of dignity, the term remains a vague, complex and interpretable concept and has not yet been given a comprehensive and specific definition by consensus experts. On the other hand, the concept of dignity overlaps with other human values ​​including privacy, respect, and independence (1).

Hospitalization of neonates in intensive care unit leads to psychological vulnerability of their mothers so that they need urgent care support. Given the impact of psychological empowerment on coping with stressful situations, this study aimed to determine the effect of psychological empowerment training on maternal resiliency of premature neonates hospitalized in intensive care unit.

This study was a quasi-experimental, single-group pre-test and post-test study in which 40 mothers of premature infants admitted to neonatal intensive care unit were enrolled. The psychological empowerment training program for mothers was conducted in 7 sessions of 45 minutes in groups of 4-5. Before and after the intervention, the data were collected using demographic questionnaire and Conner Davidson questionnaire and analyzed using appropriate statistical tests.

The results showed that the mean score of resiliency and all its subscales after intervention were significantly higher than before. The mean total resilience score was increased from 33.93 ±9.75 to 72.45 ±5.63 (P <0.001).

Psychological empowerment training can increase maternal resiliency of neonates hospitalized in intensive care units. Therefore, due to the important role of mothers in the care of premature infants admitted to intensive care units, increased maternal resilience can lead to improved care of premature infants.

Pain management program can be helpful in patients with loss of consciousness due to decrease in analgesic drugs, prolonged hospital stay; and also decrease in cost of admission, medicine and medical treatment. The current study was done aimed to determine the effect of pain management algorithm on level of consciousness in patients with loss of consciousness .

In this randomized clinical trial study, 90 patients with loss of consciousness under mechanical ventilation were selected through convenience method and were randomly allocated into two groups of 45 people as the intervention and control groups. Pain management algorithm was implemented in intervention group for 24 hours in morning shift between 8-10, evening shift between 15-17 and in the night shift between 22-24. Data collection tools were the demographic information form and Glasgow Coma Scale (GCS) and Behavior Pain Scale (BPS).

. In terms of level of consciousness, there was no significant difference between the two groups after the intervention, but the mean of volume of sedation drugs was significant different between the two groups in morning and night shift (p<0.05)

The use of the pain management algorithm can significantly impact on volume of sedation but has no effect on level of consciousness.

Traumatic brain injury is the second leading cause of death in Iran. Understanding the factors affecting the clinical outcome of these patients can improve the therapeutic outcomes.

The aim of this study was to investigate the relationship between serum sodium and potassium admission time and clinical outcomes in traumatic patients.

This study is a descriptive-analytical study performed in the intensive care unit of Shahid Rajaee hospital in Qazvin. 70 mechanically ventilated headache patients who met the inclusion criteria were selected by convenience sampling. Patients were divided into two groups: hyponatremia (sodium <135) and normonatremia (sodium ≥135) and potassium level on the day of admission were divided into two groups: hypokalemia (potassium< 3.5) and normokalemia (3.5≥ potassium) . Patients in hypoatremia group were compared with normonatremia group and patients in hypokalmia group with normokalmic group.

There was significant difference between the two groups of sodium  in successful weaning (p <0.05), but, There was no significant difference in endotracheal tube extubation, length of hospital stay, duration of mechanical ventilation, and mortality rate (p> 0/05). There was a significant difference between the two groups of potassium in successful weaning and mortality rate (p> 0.05). There was no significant difference in endotracheal tube extubation, duration of mechanical ventilation, length of hospital stay (p> 0.05).

Serum levels of potassium and sodium affect the clinical outcome of head trauma patients.

Facing difficult situations have happened to all of us. One of these difficult situations is being informed about having a specific disease which can be extremely shocking and as a result, may cause mental illnesses. The purpose of this study was to investigate the effect of artificial neural network on the effect of nurses 'empathy, responsiveness and responsibility on the patients' sense of hospitalization in emergency wards.

This descriptive-correlational study was conducted in January 2020. The statistical population included the patients in the emergency wards of Namazi Hospital of Shiraz. The sample size was calculated using 195 Cochran formula. Samples were selected using available random sampling method. The tool used in this study was a standard questionnaire with a confirmed validity and reliability. Also, the artificial neural networks have been used for data analysis.

The mean scores of patients' evaluation of nurses' empathy were 4.42 out of 5, responsibility was 4.48, responsiveness was 4.44 and patients' sense of calm was 4.52. The normalized significance level of the independent variables on the dependent variable according to the ANN spend was calculated as: Empathy 100, Accountability 68.6 and Accountability 59.5.

In the hospital environment, different behaviors of nurses can have a great impact on the morale of frustrated patients. By creating a sense of empathy in patients with proper and timely responsiveness and good accountability (quality of services), respected nurses can develop a sense of comfort in their patients.

Oral health in patients in need of intensive care is important because it can improve the health and clinical outcomes of these patients and one of the main duties of nurses in the care of patients admitted to intensive care units is to provide oral hygiene to patients; Therefore, the aim of this article was to comparing the effect of  Salvadora persica chewing stick (miswak) and chlorhexidine mouthwash on oral health in patients  hospitalized in intensive care units.

This clinical trial study was performed on 70 patients admitted to the intensive care unit of Khatam Hospital who had endotracheal intubation and no sensitivity to herbal compounds in the age range of 18 to 65 years in spring 1398.patients with inclusion criteria were selected by convenience sampling and were randomly divided into two groups of intervention (miswak) and control (chlorhexidine). Data collection tools were demographic checklist and oral health assessment checklist which were completed by interview and observation. Data were analyzed using SPSS software version 22 and independent t-test.

The patients in both intervention and control groups were homogeneous in terms of demographic and clinical characteristics. There was no significant difference between the oral health status of patients in the first day (P = 0.2), but in the second to fourth days, the patients in the intervention group received significantly higher scores on oral health than the control group. The miswak group improved significantly; in other words, the effect of miswak on oral health was more than chlorhexidine mouthwash.

Comparing the efficacy of Salvadora persica and chlorhexidine mouthwash on oral health status of patients showed that miswak was more effective in promoting oral health than chlorhexidine mouthwash. Therefore, due to the advantages of herbal compounds, Salvadora persica can be a suitable alternative to chlorhexidine.

Chest tube removal after open heart surgery is of particular importance due to changes in physiological parameters.  The aim of this study was to determine the effect of foot reflexology massage on physiological parameters during chest tube removal after open heart surgery.
 

The double-blind, three-group, randomized, controlled, clinical trial study was conducted in Baqiyatallah and Jamaran hospitals in Tehran, Iran in 2011-2012. 88 patients were selected by convenience sampling and randomly allocated to the three groups intervention (29 patients), placebo (30 patients) and control (29 patients) by six-block random assignment. Before and after the intervention, vital signs and oxygen saturation percentages were measured immediately, five, ten and fifteen minutes later in all three groups. Data were analyzed by SPSS software version 18 and using descriptive and inferential statistics (One-way ANOVA and paired t-test).
 

Results showed a significant decrease in heart rate and respiratory rate in the intervention group after chest tube removal (p <0.0001); Changes in mean systolic blood pressure and oxygen saturation percentage werenot significantly different between the three groups in different times (P <0.05).

Foot reflexology massage in the process of thoracic tube extraction after coronary artery bypass graft surgery is effective in reducing the heart rate and respiratory rate to normal values and can be a useful and uncomplicated nursing intervention. however, further studies are needed to prove this.