Journal of Caring Sciences
Volume:1 Issue: 2, Jun 2012

Episiotomy is a medical intervention in delivery which is still one of the most common surgical procedures. Topical phenytoin cream possesses analgesic, anti-bacterial and anti-inflammation effects as well as accelerating tissue healing. Hence, the present study aimed to compare the effect of topical phenytoin cream with betadine solution on pain reduction of episiotomy incision. In this double-blind clinical trial, 120 primiparous women with episiotomy that were referred to Al-Zahra Medical Center of Tabriz in 2010 were randomly allocated to phenytoin or betadine groups (60 in each group). Pain assessment was determine and compared using visual analog scale (VAS) in the first 24-hours and then in the 10th day after delivery. Data analysis performed using chi-square, independent t-student and repeated measurements ANOVA tests. The mean pain intensity in the first 24-hours postpartum was 4.39 ± 1.11 in phenytoin group and in betadine group it was 7.11 ± 1.48 (p < 0.001). In the tenth day after delivery, mean pain intensity in phenytoin and betadine groups was 0.72 ± 1.04 and 3.45 ± 2.00 respectively (p < 0.001). The results showed that local phenytoin is effective on reducing the pain of episiotomy wound and can be replaced with betadine.

Disclosure of cancer diagnosis is one the main challenges in caring of patients with cancer since it may have negative effects on the spiritual health of patients. No study has ever been performed in Iran to investigate the relationship between awareness of cancer diagnosis and spiritual health in cancer patients. Therefore, the present study aimed to review the effects of awareness of cancer on spiritual health in patients with cancer. This was a descriptive-comparative study conducted in Shahid Ghazi Tabatabaei University Hospital in 2009. The subjects included 150 patients aware of their cancer diagnosis and 150 unaware patients. The patients were selected through convenient sampling method. Using a questionnaire, the patient's spiritual health was assessed. Data analysis was conducted in SPSS17 using descriptive and inferential statistics. Results showed the mean (SD) of spiritual health among aware and unaware patients to be 75.1 (3.8) and 75.4 (3.9), respectively. Statistically, there was no significant difference between the spiritual health of the two groups (p = 0.96). These findings showed that awareness of cancer diagnosis had no effects on spiritual health of patients. It is not surprising considering Iranian culture. However, confirmation of this finding requires further studies.

There are many non-pharmacological methods for relieving labor pain. The preferable method is certainly the one that is effective and harmless. Therefore, we decided to compare the efficacy of massage therapy and breathing techniques on pain intensity, physiological responses to labor pain, labor type and the outcomes. A quasi-experimental study was conducted in Alzahra Hospital in Tabriz. At first, 4o primigravidas, satisfying the inclusion criteria, were selected and randomly divided into two groups of massage 1 (M1) and breathing 1 (B1). Then, another 42 mothers were selected based on the same criteria and randomly divided into two groups of massage 2 (M2) and breathing 2 (B2). An educated researcher assistant (ERA) provided practical training to (B1 and B2 groups) by holding one educational session. As the labor process started, the ERA, who was present at the labor room, repeated the breathing technique for B1 and B2 groups. The breathing groups employed the techniques during the first or second stage of labor at 4, 6, 8 and 10 centimeter of dilatation for 30 minutes. The intensity of pain was measured by a numerical rating scale (NRS) 30 minutes after determining dilatation. The physiological responses were evaluated at the same time intervals. The ERA performed massaging at the same dilatations for M1 and M2 groups. The data was collected similarly. Labor progression was evaluated by the partograph. Massage at 4 and 6 cm dilatations and breathing at most dilatations decreased pain scores significantly. The mean difference of pain intensity and physiological responses to pain was not significant between the massaging and breathing groups at most dilatations. Based on the findings of this research, providing the possibility of choosing one or both methods for labor pain relief and decreasing cesarean section rate is suggested.

Nursing care is considered as an essential component of health services. Patients’ health improvement depends upon the quality of nursing care. As an important principle, perceptions of nurses as well as their active participation in decision-makings has an important role in the quality of services. This study aimed to determine the perception of nurses toward the quality of nursing care in psychiatric wards. In this descriptive study, we used census sampling. Seventy-six nurses employed at psychiatric wards of university hospitals in Northwest of Iran participated in this study. Quality Patient Care Scale (QUALPAC) was used to collect data. The score of each aspect and total scores were categorized as desirable, partly desirable and undesirable. The collected data were analyzed using descriptive statistics. Findings showed that 60.5% of nurses perceived the quality of nursing care as desirable, while 65.8% and 53.9% reported the quality of physical and communicational aspects of care as desirable. Moreover, 51.3% of nurses considered the quality of care in psychosocial aspect as partly desirable. Although research findings indicated the desirability of care quality from the perceptions of most nurses, designing and applying educational programs and continuous evaluation are necessary to improve nursing care quality especially in psychosocial aspects in these centers.

Improved survival of very low birth weight (VLBW) premature infants requires urgent intensive care, professional nursing and medical care. On the other hand, long hospital stay period imposes emotional and economic burdens on the family and society. Therefore, it is necessary to clarify the most important factors affecting their hospitalization duration to lessen unwanted outcomes of premature birth and to eliminate or relieve the problems.

In a descriptive-analytical study, 170 low birth weight premature infants were assessed in a regular daily follow-up in Alzahra Hospital, Tabriz, Iran. Probable factors affecting NICU (neonatal intensive care unit) stay, such as birth age and weight, time of trophic feeding initiation, time of regain birth weight, and duration of parenteral nutrition, were evaluated. Data was analyzed using descriptive statistics and linier regression model in SPSS14. Statistical significance was considered at 0.05.

Mean birth weight and age of infants were 1310.26 ± 804.26 g and 30.51 ± 0.34 weeks, respectively. Duration of NICU stay was 14.51 ± 10.12 days. Intrauterine growth retardation, positive C-reactive protein (CRP) and blood culture during hospitalization stay, bloody or bile stained gastric remnants, days to regain birth weight, and total enteral nutrition intolerance were the most important factors affecting NICU stay among the studied infants.

It seems that eliminating risk factors of intrauterine growth retardation during pregnancy, preventing perinatal and nosocomial infections and taking suitable and tolerable feeding strategies will be effective on NICU stay duration in low birth weight premature infants. Therefore, required policies, especially early trophic feeding, are suggested to eliminate the existing difficulties.

Knowledge, attitude, and skills of nurses regarding evidence-based medicine are some of the important individual potentials in the implementation of these cares. There is no evidence indicating Iranian nurses to have these individual potentials. Therefore, the aim of this study was to determination the perceptions of nurses about individual potentials in evidence-based nursing and its related factors. In this descriptive correlational study, all nurses (n = 600) working in teaching hospitals affiliated to Tabriz University of Medical Sciences, Tabriz, Iran were included. Valid and reliable translated questionnaires were used to collect data. Descriptive and inferential statistics were employed in SPSS to analyze the data. Based on our findings, moderate levels of knowledge, attitude, and skills were possessed by 274 (45.7%), 394 (65.7%), and 411 (68.5%) nurses, respectively. In addition, male nurses (p = 0.002) and those with a master's degree (p = 0.001) were more knowledgeable. Likewise, more positive attitudes were demonstrated by females (p = 0.004) and nurses with a master's degree (p = 0.04). A statistically significant difference was found between skills and employment status of nurses (p = 0.002). The moderate level of attitude among nurses can provide a good potential in promoting evidence-based nursing in teaching hospitals affiliated to Tabriz University of Medical Sciences. Therefore, more attention should be paid to enhance the awareness and skills of nurses toward evidence-based care.

Nowadays, the chronic diseases are known to be associated with lifestyle risk factors. Hemodialysis patients encounter considerable amount of physical, mental and social pressure. Lifestyle is important because it affects quality of life and has important role in prevention. This study aimed to compare the lifestyle of hemodialysis patients and outpatients in health clinics of Tabriz. This was a case-control study on 155 hemodialysis patients and 155 outpatients referring to five dialysis centers and clinics, who met the inclusion criteria. Demographic data and some questions about lifestyle in nutrition, stress, physical activity and smoking were asked. The history of hypertension among hemodialysis patients was 34.6% greater than outpatients. High daily salt consumption (more than two tablespoons a day) was 40.5% higher among hemodialysis patients than outpatients. In terms of saturated oil intake, it was 30.8%higher among hemodialysis patients. Problem in communicating with family members was 69.8% higher in hemodialysis patients. In terms of physical activity, 46.4% of outpatients had higher physical activity like walking. Lifestyle in different dimensions was associated with chronic kidney disease (CKD); therefore, the officials of health system are recommended to develop a program to combat chronic diseases and integrate it with providing the first-level health services. It seems that public education can have a major role in lifestyle modification and in chronic kidney diseases prevention.

Despite the importance of quality of life (QOL) in outcomes of cancer patients, there have been a few Iranian studies investigating the Iranian patients’ quality of life. The present study aimed to assess the cancer patients’ QOL and its related factors. This cross-sectional study conducted in Shahid Ghazi Tabatabaei Hospital affiliated to Tabriz University of Medical Sciences in 2009. The samples included 150 cancer patients aged more than 18 years who were aware of their own diagnosis. They were selected through convenient sampling method and European Organization for Research and Treatment of Cancer–Quality of life questionnaire (EORTC–QOL 30) were completed. Our findings showed that 44.1% of the patients had moderate QOL. QOL had a significant correlation with the level of family support (p = 0.002). Many of cancer patients have a moderate QOL. However, confirmation of such finding requires further investigations.