Journal of Caring Sciences
Volume:11 Issue: 3, Aug 2022

Sleep contributes a pivotal part in neurological improvement of new borns. New-borns admitted to neonatal intensive care unit (NICU) perceive many sounds of monitors and this disturb their rest period. To enhance the sleep duration of neonates many non-pharmacological methods are available like placing newborn in a nest made with rolled cotton bed sheet and wrapping the baby with white cotton cloth. In this research effect of these two positions were assessed.

A randomized clinical trial was carried out on 76 preterm neonates in NICU of a tertiary care center. Neonates were included in the study by random method. Sleep duration and frequency of arousal was assessed through direct observation. Physiological parameters were assessed by using cardiac monitor. The information collected were analyzed using SPSS version 21.

Sleep duration of nesting group showed significantly higher than swaddling group, which mean (SD) was 206.4 (28), 183.1 (34.78) minutes, respectively. Additionally, waking up was observed less frequency in the nesting group.

Nesting enhances the duration of sleep among preterm neonates and hence this can be given priority in NICU.

Although several studies have highlighted the beneficial effects of Aloe vera on burn wounds, limited clinical evidence exists in this regard. This study aimed to evaluate the impact of the Aloe vera gel on healing, itching and pain of burn patients.

This clinical trial was conducted at Sina Hospital in Tabriz, Iran. The patients with second and first degree burn wounds on symmetrical organs, were randomly assigned to control (n=34) and experimental (n=34) groups. The Aloe vera gel and silver sulfadiazine cream were used in the experimental and control groups, respectively. To assess the healing effects, the Bates-Jensen Wound Assessment Tool (BWAT) was employed. Regarding itching and pain, visual analogue scale (VAS) was used for precise evaluation and comparison on days 1, 3, 5, 7, 9 and 14. The data were analyzed using SPSS version 13.

Although the wounds in both groups healed up completely within two weeks, the healing process among the patients in the experimental group was faster. The peak of wound itching was on day 7 in both groups. The wound itching significantly reduced half an hour after being dressed with Aloe vera gel. The wound pain in the experimental group was less than control group during the study period. Moreover, there was no pain in either experimental or control group on day 14.

Aloe vera is an effective agent in reducing itching and pain, and it can substantially increase the rate of healing. Accordingly, this agent can be considered in the treatment of burn wounds.

Music is a non-invasive, inexpensive and non-pharmacological nursing intervention that has no side effects and can be effective when provided alongside the routine care in cardiothoracic and vascular surgery (CTVS) ward and intensive care unit (ICU). The objective of the study was to assess the effect of music on pain, anxiety and physiological parameters among the post-operative sternotomy patients from CTVS ward and ICU in Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

A randomized controlled trial research design was used to conduct the study among 70 post-operative sternotomy patients. The pain score, and anxiety level were recorded using Numerical Pain Rating Scale (NPRS) and post-operative anxiety scale, with the physiological parameters recorded for both groups before the music intervention, after the first post-operative day, and after the intervention on seventh post-operative day. Data were analyzed by SPSS software version 23.

There was a marked reduction in the mean score of pain, anxiety, systolic and diastolic blood pressure (SBP & DBP), heart rate and respiratory rate in the study group as compared to the control group. There was a significant difference between the mean score of pain, anxiety, SBP, DBP, heart rate, respiratory rate and oxygen saturation in both groups after the intervention.

Music was found to be effective on pain, anxiety, diastolic blood pressure, heart rate and oxygen saturation among post-operative sternotomy patients. Thus, it is essential to include music as a tool in post-operative care.

Respect for dignity is the core of nursing. Dignity assessment improves nurses’ understanding of the level of people’s need for it. Yet, there is no valid and reliable culturally-appropriate instrument for dignity assessment among elderly people in Iran. This study aimed to develop and evaluate the psychometric properties of the Elderly Dignity Questionnaire (EDQ).

The methodological study, EDQ items were generated based on the results of a qualitative study with conventional content analysis approach into dignity and the existing literature. For qualitative and quantitative face and content validity assessments, ten experts rated item then, item impact score and content validity ratio and index were calculated. Construct validity of EDQ was assessed via the exploratory factor analysis and using the data collected from 200 elderly people. Criterion validity was tested using the Rosenberg’s Self-Esteem Scale. Reliability testing was performed via the internal consistency and the test-retest stability assessments and data was collected from twenty elderly. Data were analyzed using SPSS software version 13.

Factor analysis loaded the forty items on six factors. factor six was combined with factor five due to its limited number of items. The five factors were labeled as roles and responsibilities (twelve items), familial and social relationships (seven items), self-dignity (ten items), authorization (four items), independence, and integrity (seven items). The Cronbach’s alpha and the intraclass correlation coefficient of EDQ were 0.91 and 0.86, respectively.

This study confirms EDQ’s validity and reliability. Thus, this questionnaire can be used for dignity in the elderly.

Clinical decision-making related to coronavirus disease 2019 (COVID-19) is a new experience; thus, there is a lack in knowledge in this area. The aim of this study is to explore critical care nurses’ experience of intuitive decision-making in patients diagnosed with COVID-19.

In this qualitative descriptive study, 16 nurses who had the experience of providing care for patients diagnosed with COVID-19 were selected through purposive sampling and participated in semi-structured interviews. The interviews were transcribed and finally analyzed through the conventional content analysis approach.

62.5% of participants were females and the mean (SD) of the participant’s age and working experience were 36.56 (6.58) and 12.62 (5.59) years, respectively. Three main themes emerged out of the experiences of the nurses, including (a) inner revolution, (b) holistic awareness and (c) clinical wisdom.

Critical care nurses use intuition in novel, complex situations where they often have to make quick and independent decisions. Understanding the phenomenon of intuition in clinical decision making increases the professional practice of nursing and leads to better quality care for patients, especially in acute, critical situations and pandemic diseases.

The major role of nurses in caring for patients puts them in a position where they can feel a sense of independence or lack of autonomy in dealing with patients throughout their actions. The present study aimed to explain patients’ lived experiences of paternalistic care behaviors.

This qualitative research was conducted with the design of hermeneutic phenomenology consistent with Heidegger’s philosophical view and using the purposeful sampling method. Data richness was achieved after 13 interviews with 7 patients who had been hospitalized and received care in the hospitals of Tehran, Iran. The data were collected during 8 months (November 2020-June 2021) using an unstructured interview and analyzed using Diekelmann et al seven‐step approach with MAXQDA version 10 software.

Data analyses revealed four themes, thirteen sub-themes, and one constitutive pattern (duality of support and suppression of independence) forming the structure of patients’ lived experience of paternalistic caring behaviors. The themes included (1) Support at helplessness, (2) Inflexibility (3) Vague awareness, and (4) Despair due to lack of autonomy.

The meanings discovered in this research revealed that patients have dual emotions regarding paternalistic care behavior. On the one hand, they are pleased with the care provided, but on the other hand, they feel desperate and unable to make decisions due to being deprived of their independence. We can see the creation of new ethical values in care behaviors. Performing supportive care behavior with emphasis on patient participation should be considered as a key ethical principle in patient care.

The inevitability of human mortality encourages the care system to enhance the quality of life (QOL) at the end of life. However, the main problem is that the boundaries of care as end-of-life care (EOLC) have not been defined precisely. Hence, this study aimed to clarify the concept of EOLC.

This study was conducted based on Walker and Avant’s eight-step approach (2019). A detailed review of the literature was accomplished in the databases including PubMed/Medline, Web of Sciences, Scopus, EMBASE, and Google Scholar from January 2010 to September 2020 using the keywords ‘Terminal Care’, ‘Hospice Care’, ‘Nursing Palliative Care’, and ‘End of Life’. Out of a total of 302 articles obtained, 14 articles were included in the study.

The properties of EOLC included the following items: palliative care; improving QOL; reducing pain and suffering from physical, psychological, and psychological symptoms; and filling the gap between treatment teams and family caregivers through considering ethical issues and respecting patients’ independence. Furthermore, through taking a team approach, EOLC helps the family with physical, emotional, social, and spiritual supports. EOLC is a comprehensive and compassionate process that does not hasten or delay death, but respects and comforts the patient.

The EOLC can be defined as a palliative and humanistic care with a holistic and team-based approach focusing on all dimensions of the patients and their families. It also improves well-being at the end of life or even at the time of death, and helps the families with their grieves.

Oropharyngeal colonization with pathogenic organisms contributes to the development of ventilator-associated pneumonia (VAP) in intensive care units (ICUs). Oral hygiene care (OHC) is a very effective method for reducing the risk of VAP in these patients. This study aimed to evaluate recent OHC strategies to decrease VAP.

Randomized clinical trials (RCTs) published in the PubMed, Scopus, Embase, Cochrane Library, and Web of Science databases from inception to September 10, 2020 were reviewed to compare the effects of selective oropharyngeal decontamination (SOD) on the incidence of VAP in adult patients requiring mechanical ventilation.

Out of a total of 1098 articles reviewed, 17 eligible studies were included for final analysis. The results showed that the use of chlorhexidine for oropharyngeal decontamination reduces the incidence of VAP. However, it had a small effect on gram-negative resistant bacteria. Also, it was observed that the combined use of colistin and chlorhexidine was more effective than chlorhexidine alone in preventing VAP. The results of studies on the use of toothbrushes to reduce the incidence of pneumonia are unclear since they used chlorhexidine at the same time. However, tooth brushing is one of the best ways to maintain oral hygiene. Using povidoneiodine, Nanosil, and non-absorbable topical antibiotics reduced the incidence of VAP, while Iseganan did not show a significant effect in this regard.

The prophylactic use of topical bactericidal agents in critically-ill patients is effective in reducing the incidence of VAP. However, the use of non-absorbable topical antibiotics is more effective than other methods in oropharyngeal decontamination.