نشریه پرستاری مراقبت ویژه
سال دوم شماره 2 (پیاپی 3، تابستان 1388)

Bronchiolitis is the most common disease among the disorders caused by poisoning effect of mustard gas. This study was to evaluate the performing of collaborative care model on quality of life in chemical injured patients with bronchiolitis. In a quasi-experimental study, 36 patients with bronchiolitis selected non-randomly and collaborative care model performed on them for 3 month by participatory style of training visits and follow-up visits. The quality of life measured by SF-36 questionnaire before and after intervention. Data analyzed by paired T-test. The mean total score of quality of life increased from 29.7 to 34.3, before to after intervention which was statistically significant (p<0.001). Although diseases such as chemical injuries have no cure like other chronic diseases, but implementation of care models such as collaborative care model on chemical injuries with bronchiolitis promote their quality of life.

This study was to investigate the effect of foot reflexology on sternotomy pain of patients undergone CABG surgery. In a quasi-experimental study, 90 patients randomly divided into three groups of case, control and placebo. The reflexology group received a 10-minute left foot massage in desired location, twice a day with 6-hours interval for 2 consecutive days. The placebo group undertook a 10-minute right foot massage and the control group receiving no intervention, only at the time mentioned, the amount of visual analogue scale measured. The mean of pain intensity before and after intervention in three groups had a significant difference (p<0.001). Average of pain intensity in the case group before the intervention was 6.4(±2.1) and after intervention was 3.4(±5.1). The mean of pain intensity in control group before and after intervention was respectively 5.1(±1.7) and 5(±1.9). Independent t-test showed a significant reduction in intensity of preoperative pain between case and control groups (p<0.001). Foot reflexology appears to be a useful method for reducing sternotomy pain in patients after CABG surgery.

This study performed with the aim of assessing the effect of programmed nursing care on prevention of hemodialysis complications in under treatment patients in Shahid Beheshti University hospitals. This research is a semi-experimental one-group after and before study. 30 under hemodialysis patients selected non-randomly. These 30 patients once considered as control group and once as case group. The data collecting instrument consist of two checklist and demographic specifications questionnaire. The nursing care protocol supplied based on valid references and professional acceptance. Nursing care protocol contained preparing of hemodialysis machine, preparing of patient and machine connecting to patient, caring during hemodialysis (blood pressure control every 0.5 to 1 hour and checking the complication and its removal) and caring immediately after hemodialysis included control and chart of weight, blood pressure and hemorrhage after disconnecting of patient from machine. Data analyzed by Fisher exact test. There were significant differences at frequency of hypotention, hypertention, nausea and vomiting and muscles cramp after and before care performing stages. Nurses can decrease hemodialysis complications in patients by performing programmed nursing care that finally cause to longevity of life with lower complication and more satisfaction.

Enhancing the quality of dialysis is the main factor for reduce complication and mortality rate in patients with chronic renal disorder. But, it is not yet clear that what amount of dialysis uremic patients needs. The aim of this study was to assess the adequacy of dialysis base on urea kinetic modeling in hemodialysis ward of Motahari hospital of Jahrom. This is a cross-sectional study performed on 68 patients that admitted in hemodialysis ward with chronic renal failure diagnosis. For data gathering used researcher-made questionnaire. Its face and content validity accepted by agreement of 10 professors at university and its reliability accepted by test-retest method (r=0.85). KT/V formula used to assess the adequacy of hemodialysis. Data analyzed by parametric and non parametric tests. The mean age of samples was 58.55±18.62 years. The mean of KT/V and URR were 0.963±0.757 and 51.6±87.9, respectively. Paired T-test showed significant differences between means of blood pressure, weight, BUN and Cr before and after dialysis. According to low hemodialysis adequacy in this hospital, like most results of studies in other centers, it's needed to carry out main and prefect study to determine inadequacy dialysis causes on hemodialysis patients.

Coronary artery disease patients cure by three different medical methods includes drug, nonsurgical intervention using balloon catheter and graft-way for blocked artery. This study was to evaluate the advantage of two CABS and drug methods by measuring quality of life of people undergone those treatments. In a descriptive-analytical study, 190 coronary artery disease patients treated with drug or surgery methods selected by purposeful sampling method from the list of one of Tehran hospital patients. Then, during a structured interview, Nottingham quality of life questionnaire completed for each patient. Data analyzed by independent T test and χ2. The mean score for quality of life in patients treated with surgical and drug methods were 18.56±3.25 and 23.39±4/23, respectively. Independent T-test showed a significant difference between the two methods (p<0.05). Although CABS treatment is more difficult and cost more, but it is more apprpriate. Informing to people about this method should be more to provide comprehensive facilities and conditions necessary to apply it.

Premature born prone infant in front of many problems. So, nursing support from family of these infants is necessary. This study was to compare mothers and nurses viewpoint about importance and perceived nursing supports for parents with hospitalized premature newborn in NICU. This study is comparative descriptive. The study population consisted of mothers with hospitalized premature newborn in NICU (n=300) and nurses of three training treatment centers of Tabriz (n=32) during the first 6 months of 2007. Sampling method was census and data collected by using Nurse Parent Support Too (NPST) questionnaire. The validity of scale determined with content and translation. Reliability of scale determined with Cronbach alpha. Man-Whitney test showed that there was a significant difference between four dimensions of nursing support from viewpoint of nurses and mothers. The most important provided supports from viewpoint of nurses were "quality of care" and "emotional" dimensions and from viewpoint of mothers were "quality of care" and "informational-communicational" dimensions. Mothers wanted higher supports than they received. Therefore, it seemed necessary planning for promotion family centered care for parent’s in neonatal intensive care unit.

This study was to determine the validity and reliability of Glasgow scale modified by Palma & Cook in adult patients hospitalized in critical care unit in Iran. This study is a methodological research. After translating English version of GCSC to Persian version by international quality of life assessment method, 120 patients hospitalized in critical care unit selected by non probable, convenience, accessible and purposeful sampling. Eight observers (principle investigator, six nurses and one anesthesia resident) assessed patients and independently recorded a GCSC and Glasgow Coma scores. In addition, the PI marked a 10cm visual analog scale and recorded Richmond sedation/agitation score in order to determine the validity of GCSC. Interrater reliability for GCSC score was "excellent". Interclass correlation coefficient in trained group was 0.999 and the weighted kappa score for interrater agreement was 0.999 (p > 0.001). In validity testing, GCSC correlated highly with visual analog scale (r=0.902) and correlations with Richmond sedation/agitation scale (r=0.899) and with Glasgow Coma (r=0.970) scale (p<0.001). The GCSC confirmed as a valid and reliable tool for assessing sedation in the adult patients hospitalized in critical care units in Iran.

Training internship period has the basic role in making skills and professional abilities of nursing and obstetric students. With any rate that training is important in obstetric units, its importance is twice in intensive units. The goal of this study was to explain students’ trainers and head nurses’ experiences and their opinion about intensive unit training.

This qualitative-research is a theme analysis study In which, nine nursing students, five nursing trainers, four head nurses of surgery unit and one educational supervisor selected and interviewed based on goal sampling. All interviews were written on a paper and analyzed.

By analyzing the written texts, there were a huge number of primary themes and five main themes which had some secondary themes. Main themes were the factors related to good management of the trainers, factors about trainers experience and his enough information, factors related to manager’s supervision in higher levels to training, factors related to the experience and information of trainers and factors related to trainer's management. All the themes categorized to two strong and weak levels.

While it has been reflected from all the ideas that there are clear strengths in intensive units training, there are some weaknesses which can be eliminated by good management.