Evidence Based Care
Volume:11 Issue: 3, Autumn 2021

Hospitalization in cardiac intensive care units is always associated with negative consequences such as anxiety for patients. Since the family plays a vital role in the care of hospitalized patients, its positive effects are still questionable. The present study aimed to investigate the effect of patient companion programmed participation in primary nursing care on anxiety among patients in the cardiac intensive care unit. This study was a quasi-experimental research with pre-and post-test design with a control group. The study population consisted of all eligible patients admitted to the cardiac intensive care unit of Razi Hospital in Birjand, Iran. A total of 48 patients was selected in a control (24) and intervention groups (24) through stratified block randomization with a block size of 4 patients. The patients’ companions in the intervention group were allowed to attend the patients as planned for 3 days of 30 minutes and contribute to their clinical primary care. In the control group, the visit was still prohibited. Anxiety was measured in both groups at the beginning and on the third day of the patient’s admission using the State-Trait Anxiety Inventory (STAI). Data were analyzed using SPSS software (version 16). The results indicated that anxiety reduced in both groups 3 days after hospitalization, however, this reduction was statistically more significant in the intervention group (p=0.001). The anxiety score in the control group before and after the intervention was not significantly different (P=0.56). but  anxiety score in the intervention group before intervention was 56.29±16.79 which decreased to 46.43± 12.32 after the intervention and paired t-test showed a significant difference (P=0.01).Implications for Practice: The supportive presence of a patient’s companion in the cardiac intensive care unit significantly reduces patients' anxiety. Therefore, it is recommended to use the programmed presence and participation of the patient’s companion as a non-pharmacological intervention to reduce patients' anxiety by reviewing the sessions.

The patients undergoing kidney transplantation are exposed to Intra-Abdominal Pressure (IAP) elevation following a surgery. The present study aimed to evaluate the diagnostic accuracy of the IAP measurement method via bladder in the prediction of renal dysfunction after kidney transplantation. This longitudinal study was conducted on 135 kidney transplant patients in two hospitals in Iran/Afghanistan from February 2019 to the end of October 2019. The patients' IAP was measured by nurses every 6 h up to 24 h after the surgery. The indices of renal dysfunction were utilized, including creatinine increase and urine reduction. Doppler ultrasound was used as a golden standard diagnostic test. Data were analyzed in STATA 14. Out of 135 patients, an increase in IAP>10 mmHg was observed in 9.5% of cases. Urinary loss and creatinine decrease more than 25% of baseline indicated a significant correlation with IAP mean difference (P=0.001) (4-1). Therefore, IAP could predict renal dysfunction based on the reduction of urinary volume and a decrease in creatinine of more than 25% of baseline. Finally, a comparison between the diagnostic power of the IAP measurement method and Doppler ultrasound indicated 90% of sensitivity and 94% of negative predictive value in predicting renal dysfunction.Implications for Practice: As evidenced by the obtained results, the IAP measurement via bladder catheter might be a primary test to predict renal dysfunction before Doppler ultrasound; nonetheless, further research is required.

Spiritual intelligence training, as one dimension of comprehensive care and a means of communicating with a higher power (God), can increase mothers' hope and self-transcendence. This study aimed to determine the impact of spiritual intelligence training on hope and selftranscendence in the mothers of premature neonates hospitalized in the ICU of Fatemieh Hospital, Hamadan. This randomized clinical trial study included 80 mothers with premature neonates hospitalized in the neonatal intensive care unit in Iran in 2019. The permutated block method was used to randomly divide the eligible participants into intervention and control groups. Weekly training sessions were held in a hybrid of virtual and face-to-face formats for eight 90-minute sessions for the intervention group, while the control group did not receive any education. The maternal demographic and neonatal clinical characteristics form, the Hope Scale of Mothers with Premature Neonates, and the Self-Transcendence Scale were used for data gathering. The mean ages of the participants in the intervention and control groups were 30.18±3.76 and 29.38±1.52 years, respectively, and about 45.2% of the neonates were firstborn. The results of repeated-measures ANOVA showed that after spiritual intelligence training, the mean scores of selftranscendence (51.42±1.81) and hope (160.10±7.75) significantly increased in the intervention group (P<0.001). Implications for Practice: It is possible to ensure that mothers provide quality and comprehensive care, allowing them to better perform the parent role, using mechanisms that can increase their hope and self-transcendence.

Self-care behaviors contribute greatly to the management of multiple sclerosis (MS) and the prevention of its complications. The family has a critical role to play in the adoption of these behaviors in these patients. The present study aimed to assess the effect of the family-centered empowerment model on the self-care behaviors of MS patients. This experimental study was performed on 60 patients referred to the MS Clinic of Ghaem Hospital in Mashhad in 2020-2021. The subjects who met the inclusion criteria were non-randomly assigned to two groups of control and experimental. Data collection tools included the demographic information form and the Performance Assessment of Self-care Skills (PASS) which were completed before and one month after the intervention in both groups. The educational content was presented to the experimental group in eight 45-60 min sessions in accordance with the family-centered empowerment model, while the control group received the routine training. Data were analyzed in SPSS software (version 16) using independent t-test, analysis of variance, and Mann-Whitney test. The majority of participants in the experimental and control groups were female, single, and hold a diploma. The mean total scores of self-care behaviors after the intervention were obtained at 38.86±6.24 and 42.20±6.17 in the control and experimental groups, respectively. After the intervention, the mean total score of self-care behaviors and their dimensions in the experimental group was significantly higher than that in the control group (P<0.05).Implications for Practice: Hugo point massage with ice is suggested to be used as an available, efficient, and cost-effective method before arterial blood sampling.

Considering the complications of covid-19, in order to improve the quality of the care services and ensure of the continuity of these care services out of the hospital, telenursing should be taken.

This study aimed to evaluate the effect of telenursing on the self-efficacy of the covid-19 patients after discharge from hospital.

 This clinical trial was conducted on 66 covid-19 patients in sabzevar vasei hospital, Iran, during 2021. This participants have been divided to intervention and control groups with permutation blocks of random allocation method. Data collection tools included the demographic questionnaire and the covid-19 Prevention, Recognition, home-management self-efficacy scale were completed online by the participants before and one month after the intervention. A workshop through multimedia app and telenursing was performed to educate patient in the intervention group for one month. The control group only received the usual care at discharge. Finally, the data were analyzed using SPSS software (version 24) through the independent t-test, paired t-test, Chi-square test, and Fisher's exact test.

In the control group, the average scores of self-efficacy before and after routine training were 165.66 ±15 and 159.69± 21 21.73, respectively, and in the experimental group before and after telenursing were 144.24± 20.58 and 172.15±13.28, which was significant difference between results (p <0.001).Implications for practice: It seems that telenursing was effective on self-efficacy of patients. Accordingly, nursing team are recommended to use telenursing to improve the self-efficacy of the covid-19 patients.

The COVID-19 outbreak has adverse effects, including stress, unhealthy lifestyles, and lack of glucose level control on diabetic patients.

This study aimed to evaluate the preventive behaviors and perceived stress levels in patients with diabetes during the outbreak of COVID-19.

This cross-sectional (analytical) study was conducted with a convenience sampling method with 427 diabetic patients (type 1 and type2) in Iran from September to December 2020. Perceived stress and preventive behaviors questionnaire was used to collect information by questionnaire sharing between diabetes-related channels and groups on Social networks available. The statistical analyses included the independent sample t-test, ANOVA, and multiple linear regression.

The majority of participants were females (66%) with type 2 diabetes (693%). The mean score of perceived stress and preventive behaviors were 31.69 ± 5.88 and 67.00 ± 8.09, respectively. The perceived stress in patients with type 2 diabetes (32.05±5.7) was higher than in type 1 (30.87±6.06). Females (67.69±7.82) were with a higher mean value in preventive behaviors than men ( 65.64±8.47). The effective predictors for perceived stress and preventive behaviors in diabetic patients were gender, occupation, and access to medicine. In conclusion, the mean scores of perceived stress and preventive behaviors were approximately high and moderate. The high perceived stress score referred to the increased stress level and the moderate preventive behaviors as health protocols adherence.Implications for Practice: The necessary measures should be taken to reduce psychological stress and enhance a healthy lifestyles for better management of diabetes during COVID-19 outbreak.

The Coronavirus Disease 2019 (COVID-19) pandemic and lockdown have had a profound impact on the emotions, anxiety, and mental health of communities and premature infants as one of the most vulnerable groups in society whose health depends on the health of the mother. This study aimed to determine the psychological impact of COVID-19 on mothers with premature infants admitted to the neonatal intensive care unit (NICU). This cross-sectional study was conducted during the COVID-19 pandemic from December 2020 to March 2021 through convenience sampling on 190 mothers whose preterm infants were admitted to the NICUs of the selected hospitals in Isfahan, Iran. Corona Disease Anxiety Scale, a Multidimensional Scale of Perceived Social Support, and Maternal-Neonatal Demographic Characteristics were used for data collection. The obtained data were analyzed using t-test, ANOVA, Pearson correlation coefficient, and multiple regression. The mean total score of COVID-19 anxiety (12.21±10.31) was reported at a mild level, and perceived social support (66.55±12.81) was at a high level. Based on the final results of the multiple regression model, COVID-19 anxiety, and the levels of mothers' income and education were significant predictors of perceived social support. No significant relationship was observed between COVID-19 anxiety and perceived social support.Implications for Practice: The results showed that the levels of psychological factors and their relationship with other factors can be varied in the COVID-19 pandemic condition. Therefore, a decrease or an increase in the perceived social support did not affect the level of COVID-19 anxiety in mothers with premature infants.

The process of applying Evidence-Based Practice (EBP) in the clinic has been slow in various departments and disciplines. In particular, according to the results of studies, EBP use is much less common in the operating room than in medical wards.This study aimed to evaluate the use of EBP in surgical care and identify barriers to its application among operating room and anesthesia nurses. This cross-sectional descriptive study was conducted using online survey tools on 251 operating room and anesthesia nurses from Mazandaran teaching hospitals, Iran, January 2021. The EBP Implementation (EBPI) Scale and EBP BARRIERS Scale were used to assess the extent of EBP and barriers, respectively. The mean use of EBP was 27.73±8.73 (range: 0-72). The results showed that about 50% of the participants had never used EBP in the past 8 weeks. The EBP application showed an inverse relationship with age (P<0.01, r=-0.30) and work experience (P<0.01, r =-0.20). Education had a significant effect on the process of EBP (P<0.01). There was a positive correlation between the EBP BARRIER scale and EBPI Scale (r=0.34, P<0.01). The major barrier for the use of EBP was "The lack of authority to change patient care procedures". The results of this study can be used along with evidence-based information to plan the organization's strategy to increase the use of EBP in daily practice.