Evidence Based Care
Volume:1 Issue: 1, 2012

Applying “Roy Adaptation Model" in caring of patients with diabetes needs a context based planning using the principles of this model. But no study has been done up to now in Iranian nursing context To examine the effect of employing a care plan based on the Roy Adaptation Model on psychological adaptation in patient with type II diabetes. This clinical trial was performed on 60 patients admitted in Parsian Diabetes Foundation in Mashhad in 2009 (random allocated: 30 patients in intervention and 30 patients in control group). The intervention group received a care plan designed based on Roy adaptation model for 10 week interval followed by a follow-up period for 6 weeks later, while the control group only received the regular services from the Foundation. The data collected using demographic questionnaire, Roy assessment form”, adaptation strategies questionnaire, and HgA1C test. Chi square, Wilcocxon, and T test was applied for analyzing data using SPSS version 17. Value of p<0.05 was considered significant The results showed no significant difference in terms of level of HgA1c and the maladaptive behaviors between two groups before intervention. Nursing care based on Roy model deceased patient’s maladaptive behaviors in self concept (p=0/000) and interdependence mode in the intervention group. Level of HgA1c was decreased significantly in the intervention group (p=0/000).after intervention. No significant changes were found in the control group. Applying Roy adaptation model in caring patient with type II diabetes using holistic and interdisciplinary approach, can increased psychological and physiological adaptation. More study by longer time needs to examine the effects of this model on the “role function mode”.

Anxiety with different shapes induces some complications in women in their first pregnancy. Reducing anxiety level can promote maternal-fetal health. to examine the effect of learning the “attachment behaviors” on the anxiety level and “maternal fetal attachment” in first pregnant women referring to Shiraz obstetric clinics in 2010 In this randomized control trial 84 pregnant women were allocated in two groups randomly. Experimental group received routine pregnancy care in addition to four 90- minutes’ sessions on the attachment behaviors during one month of intervention period. The control group received usual pregnancy services. Anxiety and maternal fetal attachment were measured before and after intervention in two groups. Data were collected using Spielberger's State Anxiety Inventory and maternal fetal attachment scale Cranley. Data were analyzed with SPSS software (v.11.5), using statistical tests including Chi square, pair T test, and T test. P value less than 0.05 considered statistically significant. women in the case group experienced significantly less anxiety and more maternal fetal attachment after learning attachment behaviors (p=0.003, p<0.001). No significant changes were found in the control group. educating the attachment behaviors can increase maternal fetal attachment and reduce women’s anxiety in their first pregnancy. It could be suggested to include teaching this subject in to pregnancy health care services.

One of the most important indicators of quality of services and monitoring health services is evaluation and assessment of patient satisfaction of services that comes from sociology research. To identify the effect of providing post partum care at home on maternal received care and satisfaction. This clinical trial was carried out on 200 mothers who referred to Akbar Abad Health Care Center for their infant screening tests. They were randomly allocated to two experimental and control groups. Experimental group received their first and second post partum care at home, but control group only received routine postpartum care of the health center. Data were collected using a questionnaire containing demographic characteristics and some question to assess maternal received care and satisfaction with postpartum care. Chi square and T test were applied for analyzing data using SPSS version 18. P value less than 0.05 considered statistically significant. Most of the mothers were 20-29 years old. Two groups were significantly different in relation to percentage of received care at the first and second post partum and infant care (P=0.00, P=0.01). The average score of emotional and educational services that mothers received and also maternal satisfaction were also significantly different between two groups (p=0.00). Postpartum care provided at home, has positive effect on maternal emotional and educational received care and also their satisfaction. So we suggest post partum health care provision by health care providers at home.

Religion, spiritual well- being and hope are concepts that are frequently used as a source of coping in patients with cancer. However, few studies have examined these factors with independent measurement devices. To determine the relationship between religion, spiritual wellbeing, hope and quality of life in cancer patients admitted to Omid’s Hospital in Urmia city from August to January 2010. In this cross sectional descriptive-analytical research, 164 patients with cancer were selected using sequential convenience sampling. Data were collected using demographic characteristics form, quality of life questionnaire EORTC QOL-C30, Ellison and Paloutzain spiritual well- being questionnaire, Duke University Religion Index, and the Herth Hope Index. Data was analyzed using SPSS Software (v.11.5), statistical test Pearson correlation coefficient and multiple regressions were done and P < 0.05 considered statistically significant. Spiritual well-being (r = 0.23, p <0.01) and hope (r = 0.23, p <0.01) had a significant positive relationship with the functional quality of life scale. Spiritual well- being (r = 0.34, p <0.01) and hope (r = 0.46, p <0.01) had a significant positive correlation with the overall quality of life. Between religious practices and the overall quality of life was significant correlation (r = 0.18, p <0.05). Also hope and religious beliefs explained 25/8 percent of changes in overall quality of life. There was a significant relationship between spiritual health, religious practices, hope and quality of life. Considering some factors such as being purposeful in the life, believing in God, doing religious practices and being optimistic about the future, while providing the health cares for patients with cancer might increase their quality of life.

Anxiety is one of the emotional conditions among patients scheduled for surgery that can result in increasing postoperative pain, increasing analgesic and anesthetic requirements and prolonged hospital stay. To assess the effectiveness of listening to music and Holy Quran on patient’s anxiety and vital signs before abdominal surgery it was a blind and three-group clinical trial. Ninety patients who were scheduled to undergo abdominal surgery were randomly assigned to three groups of music, Holy Quran and control. Subjects in music and Holy Quran group listened to the music and Holy Quran for 20 minute before surgery. Control group received no intervention. Anxiety and Vital signs were measured before and after intervention in three groups. To measure Anxiety Spielberger's State Anxiety Inventory was used. Data were analyzed with SPSS Software (v.11.5), using statistical tests including Chi square, Fisher exact test and ANOVA and P value less than 0.05 considered statistically significant. Patients in music and Holy Quran group experienced significantly less anxiety (p=0.001). Listening to the music and Holy Quran also decreased patient’s heart rate (p<0.02) and blood pressure significantly (p<0.004). No significant changes were found in the control group. Listening to the music and Holy Quran is a systematic intervention and complementary treatment for pre-operative patients that can decrease the anxiety level and physiological responses to the stress of surgery

Fatigue and lack of energy is a common symptom in hemodialysis patients that affects patient's self care. It can also result in job loss, increased dependence to special health care and increased mortality. This study examines the effect of employing a care plan based on the Roy Adaptation Model on level of fatigue in hemodialysis patients. This clinical trial was performed on 54 hemodialysis patients admitted in Ghaem and Emam Reza Hospitals in 2010 (random allocated: 28 patients in intervention and 26 patients in control group). The intervention group received the care plan trough a face to face training program in 4 sessions at 3- week interval followed by a follow-up period for 4 weeks later, while the control group only received the regular services from hospital. The data were collected using demographic questionnaire, modified Piper Fatigue Scale, and Roy assessment tool. Data were analyzed using student and paired t test and also two-tailed analysis of variance with SPSS version 13. The results showed no significant difference in terms of fatigue between two groups before intervention but they were significantly different after the intervention (P =0.000). Patients’ fatigue was decreased 19% in patients in intervention group. The findings of this study indicate that the care plan based on the Roy Adaptation Model is an effective, low cost and non-invasive nursing intervention for decreasing fatigue in hemodialysis patients.

Hindering factors of clinical education is stress. Which is also health- threatening for students, Interpersonal communication skills is one of the most important stress- inducing factors. Due to mutual interaction between stress and communication skills, and importance of stress- management in clinical education courses, it is necessary to intervene properly. So, this study aimed to study the effect of communication skills education on nursing students’ coping strategies in stressful situations of clinical courses. In this experimental study, 56 students’ 3th and 4th year nursing, classified randomly in test (26) and control (30) group. Communication skills workshop was held for test group according to their own clinical course by using Role- Play method. The workshop was a two- step 10 hour course, by one week interval. Coping strategies was measured by Lazarus- Folkman questionnaire (The ways of coping scales (revised)), before and 4 week after intervention and analyzed statistically by SPSS 11.5 using T-Test, Man Whitney U- test and Chi- square. Problem-focused coping was increased in test group by 13.5 %, there was a significant difference between two groups after intervention (p=0/000). Total score of Emotional- focused coping was decreased in both groups and showed no significant difference (p> 0/005). The only significant difference in both groups was related to Escape- Avoidance strategy (p=0/043), which increased 3 times more in test group in comparison with control group. Teaching communication skills, can improve coping strategies in nursing students by increasing their application of Problem- focused methods. It is recommended; teach these skills before their clinical education courses.