نشریه پرستاری مراقبت ویژه
سال پانزدهم شماره 3 (پیاپی 55، پاییز 1401)

One of the basic needs of patients and families during hospitalization in Intensive Care Units (ICUs) is the presence of a family member beside the patient. Family participation in patient care is accepted in public wards, but unfortunately in ICUs due to the structure and prohibition of visits in these wards, this issue faces many challenges. The aim of this study was to determine the effect of family participation in patient care on the level of consciousness and the parameters of mechanical ventilation in brain injury patients admitted to the ICUs.

This study was a quasi-experimental study. Thirty brain injury patients who had referred to selected hospitals in Isfahan in 2020 were included in the study by available sampling. Patients were assigned to two groups of 15 intervention and control) by random assignment of permutation. In the first-degree family intervention group, family members were present bedside the patients for three days, twice a day at 10:00 AM and 3:00 PM and performed a family-centered care program. The control group received routine ward care. The level of consciousness and the parameters of the mechanical ventilations were recorded and measured 15 min before, during and after care. The results of the study were analyzed using descriptive and inferential statistical methods and using Chi-square, independent t-test and repeated measures analysis of variance in SPSS software version 20.

The findings of the present study revealed that the level of consciousness of the two groups before the study was not statistically significant (P>0.05) but from the third day of the intervention, the mean level of consciousness was significantly different between the two groups (P<0.05). In addition, there was no statistically significant difference between the breathing rate and the tidal volume of the patients on the mechanical ventilations during three days (P>0.05). This is while the minute volume of the patients during the three days showed a significant difference in the intervention group (P<0.05).

The results of this study showed that family participation in simple patient care in brain injury patients with low levels of consciousness can increase their level of consciousness. This means, certain conditions should be provided in such departments for family participation in simple care matters under the supervision of the ward nurses.

Hospitalization of patients in Intensive Care Units (ICU) often causes anxiety and psychological problems in family members. The aim of this study was to determine the effect of communication skills training to nurses on the anxiety in family members of patients admitted to ICUs.

This semi-experimental study was performed in the ICU of Golestan Hospital in Ahvaz in 2017.The population consisted of nurses and family members of patients of admitted to internal and neurology ICU. Internal ICU and neurology departments were randomly divided into two groups. The nurses of the internal ICU department were in the intervention group and the nurses of the neurology department were in the control group. Fifty-five family members of patients from each department were selected through convenience sampling method. A communication skills training workshop was held for the nurses of the intervention group in three consecutive days. Family members’ anxiety was evaluated using Spielberger's State-Trait Anxiety Inventory the day of admission and the sixth day of hospitalization.

The results showed that there was no significant difference between the average anxiety scores of the intervention and control groups before the intervention (P=0.38), but there was a statistically significant difference between the average anxiety scores of the intervention and control groups after the intervention (P<0.001). The results showed that there is a significant difference between the average anxiety scores of the intervention group before and after the intervention (P<0.001), but in the control group, there was no statistically significant difference between the average anxiety scores before and after the intervention (P=0.61).

Based on the findings of the present study, communication skills training for nurses reduced the anxiety of patients' family members. Moreover, since the favorable mental state of families has a significant effect on caring for the patient, the use of this method is recommended as an effective strategy in supporting patients' families.

The use of new educational methods for medical students is of great importance. Simulation method is one of these methods that can be used as personalized video feedback. The present study set to determine the effectiveness of personalized video feedback on the level of endotracheal intubation knowledge of anesthesiology students.

A quasi-experimental study was conducted with pre-test and post-test design and a control group which was performed on anesthesiology students of Ahvaz Jundishapur University of Medical Sciences in 2021. Forty-six students were selected by convenience sampling method and were randomly assigned to intervention and control groups by using the block method. A researchers-made questionnaire of demographic characteristics of students and endotracheal intubation was used for data collection. A session of personalized video feedback was performed for the intervention group in addition to a one 90-min session of endotracheal intubation trainings using a mannequin.

There was no statistically significant difference between the two groups in terms of demographic characteristics. The mean scores of endotracheal intubation knowledge of students before the intervention were 7.82)2.56(in the experimental group and 8.48)3.89(in the control group, which were not statistically significant (P=0.51). After the intervention in the experimental group, these scores changed to 11.64 )2.17(in the experimental group and 9.62)2.59) in the control group, which was a significant difference (P<0.001). Also, the mean scores of endotracheal intubation knowledge of students in the intervention group improved from the pre-test to post-test (P<0.001), while it was not so in the control group (P=0.19).

Considering the effectiveness of personalized video feedback intervention on endotracheal intubation knowledge of anesthesiology students, it is suggested to use this method in teaching endotracheal intubation skills in anesthesia students and consider it as a part of the medical clinical education curriculum.

The use of separation tools from the mechanical ventilation device compared to the usual methods implemented in Intensive Care Units (ICUs) can reduce unsuccessful extubation. Therefore, this study was conducted with the aim of determining the impact of using the airway care score on the success rate of extubation in patients hospitalized in neurosurgical and neurologCal ICUs.

In this semi-experimental study, 98 patients with epidural, subdural and intra cerebral hemorrhage were selected based on the inclusion criteria and by convenience sampling method. According to the table of randomization blocks (permutation blocks) and by using the WinPepi software 11.4, they were randomized and assigned to two interventions (49 people) and control (49 people) groups. In the intervention group, extubation of patients was performed using the airway care score tool and in case of obtaining a score of seven or less. In the control group, patients were extubated based on the opinions and experiences of anesthesiologists.

In this study, the number of re-intubation cases in the intervention group was less than the control group, but this difference was not statistically significant (P=0.2). Also, the duration of connection to the mechanical ventilation device (P=0.02) and endotracheal tube (P=0.018) and the duration of hospitalization in the ICU (P<0.001) in the intervention group were significantly less than the control group.

The use of airway care score tool reduces the number of unsuccessful extubations but this difference was not statistically significant. Also, by using this tool, the duration of hospitalization of patients in neurosurgical and neurological ICUs, the duration of intubation and also the duration of connecting patients to mechanical ventilation were reduced. Therefore, due to the lack of awareness of nurses in ICUs about extubation tools and performing the extubation process in a traditional way, it is necessary to make necessary plans by relevant authorities to increase the awareness of nurses in this field.

Background & Aims:

Accidental hypothermia is a common complication in trauma patients. Hospitalization of these patients in the Operating Room (OR) can greatly affect the prevalence of inadvertent hypothermia. Due to the negative patient's outcomes, the aim of this study was to investigate its prevalence and related risk factors among trauma patients in the OR.

This prospective observational study was conducted on trauma patients who underwent surgery in the OR department of the Educational and Treatment Center of Mousavi in Zanjan. In this study, 59 eligible patients were selected using convenience sampling method in December 2017. Individual, clinical, environmental and care variables related to hypothermia were collected by a researcher and recorded in a researcher-made data sheet.

The majority of patients (66.1%) were men. The mean and standard deviation of their age was 46.8 (17.7) years. The most common mechanism of trauma was blunt trauma (66.1%) and the main cause of trauma was motor vehicle crash (45.8%). The prevalence of accidental hypothermia in the OR was 67.8%. Eighteen independent variables were entered into the logistic regression model as factors related to accidental hypothermia, and in the final step of the model, low systolic blood pressure (OR=1.141, P=0.022), low blood oxygen saturation (OR=2.229, P=0.009), and inadequate clothing and coverage of patients (OR=8.354, P=0.039) were identified as risk factors. High OR ambient temperature (OR=0.126, P=0.035) and short duration of surgery (OR=0.086, P=0.016) also acted as protective factors.

In the current study, a significant part of surgical patients was hypothermic during operation and factors such as surgery time, systolic blood pressure, blood oxygen saturation, ambient temperature of the OR, and the condition of the patients' clothing were found to be effective in its development. This study has aimed to emphasize the need for early identification of hypothermia and effective management of related factors in order to prevent unwanted consequences.

Coronary Artery Disease (CAD) despite physical disorders can also lead to significant mental disturbances like anxiety and depression. Therefore, the present study was conducted in order to assess the level of anxiety and depression in the elderly with acute coronary syndromes hospitalized in selected hospitals in Tehran 1400.

The current study is a cross-sectional, quantitative and descriptive-analytical study that was conducted in 2021. The study population included the elderly male and female patients (over 60 years old) who suffered from acute coronary syndrome hospitalized in selected hospitals in Tehran. For this purpose, 229 people were randomly selected to participate in the study. The Abbreviated Mental Test (AMT) and Hospital Anxiety and Depression Scale (HADS) were used as questionnaries in this study.

Findings showed that with an increase of one unit of the anxiety score, if other variables were fixed, the depression score increased by an average of 0.45 units. Also, the results for other demographic variables showed that people with low education, having non-personal residence, lack of social support, families with more than four children, unemployed people and male gender had a higher depression score.

Considering the existence of a significant relationship between anxiety and depression with the mentioned variables, it is suggested that health service providers and their families pay attention to elderly patients in order to reduce the level of anxiety and depression.

Caring for patients with Covid-19 is a challenging issue. Not only does Covid-19 disrupt the lives of patients, it may also have an unpleasant effect on their caregivers. The present study was conducted with the aim of explaining the caregivers' lived experience of caring for a family member infected with Covid-19.

The present descriptive phenomenological study was conducted using the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Inductive and in-depth interviews were conducted with 17 caregivers of family members from April to July 2019 in Tehran.

In the present study, 17 caregivers of family members with the age range of 28 to 52 years who had the experience of directly caring for a family member infected with Covid-19 participated. Caregivers' experiences were classified into four themes and 11 sub-themes. The themes were: "heavy and dangerous care", "negative consequences", "helplessness" and "sacrifice".

The present study showed the challenges of caregivers of family members of patients with covid-19 during the epidemic period. As the Covid-19 pandemic continues, the situation for caregivers may become more difficult and challenging. The most important issue in such a situation can be support, which in the form of government support in the form of financial and equipment, the support of the treatment staff in the form of training and the support of close acquaintances of the caregiver can moderate the challenges raised to some extent.

Burn is one of the most debilitating type of trauma. Preparing the patient to find the optimal way to deal with the disease as well as maintaining independence and happiness in life is an essential part of the treatment process for burn patients. The aim of this study was to apply the Callista Roy's adaptation model in the care of burn patients.

This study was a case study that was conducted with the participation of a burn patient hospitalized in the burn ward of Besat Hospital in Hamedan city in 2022. Data were collected using observation, interview and patient documentation and were analyzed in four dimensions, based on the steps of the nursing process in Roy's adaptation model.

The results of the study showed that the patient had compatible and incompatible behaviors in physiological dimensions, adaptation of self-perception, role playing, independence and dependence. However, after nursing care based on Roy's adaptation model, some of these incompatible behaviors decreased. Also, based on the information obtained from the Hospital Anxiety and Depression Scale (HADS), the application of the Roy's adaptation model reduced the patient's anxiety and depression in three stages. So that the overall score of the anxiety and depression questionnaire in the second and third time compared to the first time of completing the questionnaire decreased by 67% and 68%, respectively.

According to the results of the present study, the implementation of the nursing care program based on the Roy adaptation model can be effective on physical and psychological adaptation and reduction of incompatible behaviors in patients with burn injuries.