Evidence Based Care
Volume:13 Issue: 2, Summer 2023

The decline in cognitive function occurs faster in the elderly who live in a nursing home than at home. Cognitive decline can interfere with the elderly carrying out their activities. The appropriate intervention is needed to improve the cognitive function of the elderly living in nursing homes. The present study aimed to evaluate the effect of combined anagram training and cardiac exercise on cognitive function in the elderly living in nursing homes. A nonrandomized clinical trial study was conducted. Sixty participants in four nursing homes were included in a combined intervention group (n=30) to join cardiac exercise and anagram training three times a week for 12 weeks, and in a single intervention group to join anagram training (n=30). Cognitive function was evaluated using the Montreal Cognitive Assessment before and 12 weeks after the intervention. A within-group analysis (Wilcoxon test) and intergroup analysis (Mann-Whitney U test) were used to evaluate the effects of combination intervention on cognitive function. Although both groups demonstrated a significant global cognitive function and sub-cognitive function such as executive, attention, recall, and orientation cognitive function improvement before and after the intervention (P<0.05), the combined intervention group showed a much more significant improvement compared to the single intervention group (P<0,05), except for the orientation cognitive function (P=0.674).Implications for Practice: The combination of anagram and cardiac exercise could be used as an intervention to improve cognitive function in elderly living in nursing homes.

Anxiety is one of the most prevalent psychological complications in patients undergoing cardiac catheterization. This study was performed with aim to compare the effect of organized evidence-based education by group discussion and film screening on anxiety of Coronary Catheterization Patients. This randomized clinical trial study was performed at Javad-Al-Aemeh Hospital, in Mashhad, Iran, 2018. The coronary catheterization patients were randomly allocated to the three groups. An evidence-based educational program was presented to 75 patients waiting for cardiac catheterization by 25 min film, also it was discussed with 70 patients in small groups, and 70 patients were considered as the control group. The pre-procedural anxiety was assessed using Spiel Berger Inventory before and 1 hour after the education. Data were analyzed by SPSS (version 15) andKolmogorov–Smirnov, ANOVA, t student and Paired t, Kruskal-Wallis and Wilcoxon tests. P<0.05was considered statistically significant. The three groups were not significantly different in mean scores of age (p=0.922) and left ventricle ejection fraction (P=0.112) at the beginning of the research. Three groups didn't have significant difference in anxiety score before the intervention (P= 0.58), but after the intervention, the anxiety significantly decreased in the film screening (33.72±4.92) and discussion groups (36.54±6.4) (p<0.001) compared to the control group (46.7±9.78). However, the results showed no significant difference between the film and discussion groups (P=0.09).Implications for Practice: An evidence- based education by film screening and group discussion in the cardiac wards can reduce the anxiety in catheterization candidates.

Mothers of premature infants admitted to the neonatal intensive care unit (NICU)experience stress and anxiety. Reducing anxiety in mothers is essential to ensure the quality of carefor infants with special needs after discharge. Non-pharmacological methods of managing anxiety areencouraged for breastfeeding mothers. This study aimed to determine the effectiveness of aromatherapy with Damask Rose (DR) onanxiety in mothers with premature infants admitted to NICU. In this clinical trial study, 75 eligible mothers selected through convenience samplingmethod were randomly assigned into intervention and control groups. In addition to the routine care,the mothers in the intervention group received a 5-10-minutes inhaled aromatherapy with 10% DR forten consecutive nights. The mothers of the control group only received routine care. The tools of thestudy were a demographic information form and the State-Trait Anxiety Inventory (STAI). Data wereanalyzed using SPSS statistical software (version 22). P<0.05 was considered statistically significant. The mean scores of state anxiety significantly reduced in the intervention (48.88±10.16 to40.68±8.62) and control groups (52.30±7.40 to 51.27±7.30). Due to the significant difference betweenchange in before-after scores in the two groups, aromatherapy was more effective than routine care inreducing anxiety (P<0.0001). Also, the mean score of trait anxiety significantly decreased from49.14±9.99 to 44.37±10.0 in the intervention group (P<0.0001).Implications for Practice: Aromatherapy with DR decreases anxiety in mothers of preterm infantshospitalized in the NICU; therefore, it can be recommended for the management of anxiety in thispopulation.

Demographic factors, hospital status, and comorbidities affect the mortality of patients with coronavirus disease (COVID-19). This cross-sectional study was performed with aim to evaluate the mortality predictors of hospitalized COVID-19 patients in northeastern Iran (Mashhad city). In this retrospective study, the electronic records (demographic data, clinical variables, and comorbid conditions) of survived and non-survived hospitalized COVID-19 patients were searched from March 2021 to March 2022 during six pandemic waves. Analysis of 59099 hospitalized COVID-19 patients showed the mean age of 54.4722.5 years (female: 46.92%). Binary logistic regression analysis showed that age, masculinity, respiratory distress, and loss of consciousness among demographic data and clinical variables significantly contributed to mortality (OR>1, P<0.05). Diabetes, cancer, respiratory diseases, kidney diseases, and immunodeficiency diseases increased the chance of death. High SpO2 (>93) protected against death (OR<1, P<0.05).Implications for Practice: The results of the present study revealed that the clinical outcome of COVID-19 infection is highly affected by demographic, clinical, and comorbidity factors. Several factors including age, masculinity, respiratory distress, loss of consciousness, diabetes, cancer, respiratory, kidney and immunodeficiency diseases had a risk effect on COVID-19 death during six pandemic waves. Also, high SpO2 (>93) was detected as a protective factor for death followed by COVID-19 infection.

Today, patient safety is one of the main concerns in the health care system; patient safety standards is very important in the Operating Room (OR). The present study was performed with aim to evaluate the implementation of patient safety standards by the surgical team in Iranian hospitals. This descriptive cross-sectional study was performed in 2019 on 180 surgical cases in the OR of selected centers affiliated to Isfahan University of Medical Sciences. Data collection tools was a checklist (including patients' demographic characteristics and 134 items related to 4 dimensions of anesthesia care standards before, during and after surgery, observance of essential points in safe surgery, observance of the relationship between the surgical team and the standard of patient movement and position during surgery). The highest mean score was related to observing the standards of anesthesia care before, during and after surgery (70.76 ± 10.58), then observing the essential points in safe surgery (65.41 ±19.32), observing the relationship between the surgical team (57.59 ± 18.8) and the standard of patient movement and position during surgery (25.73 ± 7.95) were in the next ranks. The performance of the surgical team in observing safety standards significantly increased with increasing age and weight (p<0.05).Implications for Practice: According to the results of this study, all members of the surgical team should be aware of safe surgery and more training programs should be developed for them to compile with the standards of patient safety in OR.

Heart failure (HF) is a chronic progressive syndrome. Patients with heart failure often experience poor self-management, anxiety, depression, poor quality of life, and frequent readmission.
The present study was performed with aim to explore the effect of self-management-based discharge planning on anxiety, depression, and readmission in patients with heart failure.
This quasi-experimental study was performed on 80 patients with heart failure admitted to two teaching hospitals of Zahedan in 2019-2020. The participants were randomly assigned to two intervention and control groups. The self-management-based discharge planning was performed for the intervention group. The intervention group was followed-up by calling 2-3 days after discharge and then every week in the first month and every two weeks in the second and third months. Data were collected using the Hospital Anxiety and Depression Scale (HADS) and a readmission frequency and duration form. Data were analyzed using SPSS software (version 16). P<0.05 was considered statistically significant.
The results showed a significant differences in the mean score of anxiety and depression over time (p<0.001) and in the intervention and control groups (p<0.001). There was no significant difference between the two groups in the readmission duration (p=0.052) and readmission frequency (p=0.801).
Implications for Practice: Self-management-based discharge planning reduces depression and anxiety of patients with heart failure. Given the ease of clinical implementation of self-management-based discharge planning, its low costs, and availability for clinical staff, it can be considered an effective method to reduce depression and anxiety in these patients.

Ischemic heart disease (IHD) is a common cardiovascular disease. One of the main concerns of health system staff is the non-compliance of these patients in adherence to treatment after discharge from the hospital. Designing and implementing a program to follow up patients after discharge can positively affect their rehabilitation and treatment adherence. This study was performed with aim to investigate the effect of discharge planning on adherence to treatment in patients with ischemic heart disease. This quasi-experimental study was performed with the participation of 70 ischemic heart disease patients hospitalized in Hamadan Cardiovascular Hospital in 2018. Participants were selected by simple random sampling and divided into experimental (n = 35) and control (n = 35) groups using permutation blocks. In the first 24 hours of admission, a researcher-made questionnaire of adherence to treatment was completed by all participants to assess the educational needs. The discharge planning consisted of two stages: before discharge and after discharge from the hospital with telephone follow-up for 2 months. Then adherence to treatment was re-assessed after discharge. Data was analyzed using SPSS software (version 22) by chi-square, Fisher's exact test, independent t-test and paired t-test. P<0.05 was considered statistically significant. Before the intervention, there was no statistically significant difference between the control and experimental groups in adherence to treatment (p> 0.05); however, after the discharge planning, adherence to treatment significantly increased in all areas in the experimental group (P <0.001).Implications for Practice: Implementation of discharge planning improves and promotes adherence to treatment in IHD patients.

Reduced social interaction in the elderly can result in isolated feelings so that the elderly prefer to be alone, which eventually can lead to depression and affect their quality of life. Social interaction in the elderly can have a positive impact on the quality of life.

The present study was performed with aim to determine the effectiveness of social interaction as a therapy to improve the elderly’s quality of life.

This quasi-experimental study with a pretest-posttest design and a control group was conducted on 40 respondents in Gedongan Village, Baki District, Sukoharjo Regency, Central Java Province in January-February 2022. The social interaction intervention was completed separately in the intervention and control groups. The instrument for measuring the quality of life was adopted from the WHOQOL-BREF. Social interaction therapy utilized sermons conducted in groups by inviting Islamic teacher to provide material to the elderly that leads to improving the quality of life.

The wald Chi-square in the treatment group was 1.744 with a P-Value of 0.006 after the post-test. Control group wald Chi-square was 8.690 with P-value of 0.999 after the post-test. So that the output regression results showed that Social interaction using spirituality therapy improved the quality of life in the elderly. The elderly who received the intervention (post-test) tend to have a very good QoL of 0.29 times compared to the elderly who have not been intervened (pre-test).
Implications for Practice: The results of the present study indicated that the social interaction can improve quality of life in the elderly and can be considered as a part of the holistic care program.