Journal of Caring Sciences
Volume:2 Issue: 4, Dec 2013

About 20-50% of patients with heart failure are readmitted to hospitals in 14 day to 6 months of hospital discharge. Several supportive programs are developed to reduce post discharge hospital readmissions. The present study was performed to review the clinical trials conducted to determine the effect of post-discharge follow-up on readmission of patients with heart failure (HF). Internet search was conducted to identify clinical trial studies that have been conducted on post-discharge follow-up care for patients with HF. Databases of Science direct, Pubmed, Iranmedex, SID and also the Google’s search engine were searched for studies that have been published between the years 1995 and 2013. Keywords used in searching Persian databases were included readmission, heart failure, continuous care, and follow-up. Keywords used in searching English databases were included of heart failure, readmission, follow-up and home monitoring. 21 clinical trials were reviewed. 16 studies have shown that continuous care through patient education before discharge, home visits, and telephone follow up could significantly reduce the rate of post discharge readmissions of patients with HF. However, five studies did not show significant reductions in post-discharge readmissions. Patient education and continuous post-discharge follow up interventions conducted by nurses could significantly reduce the rates of readmissions to the hospital or to the physicians’ office. Considering limited health care resources, using one or a combination of follow-up methods, can reduce the number of readmissions of patients with HF.

Nurses’ Caring behaviors might be affected by many variables. The aim of this study was to develop and test a valid and reliable questionnaire to specify these determinants. Both qualitative and quantitative methods were applied to develop the questionnaire. The development process of the instrument was conducted in three phases. The first phase consisted of four steps: in-depth interviews, development of the preliminary version of the 38- item DNCB, expert panel review, and language revision. The second phase involved examining 143 qualified nurses for psychometric properties of the DNCB. The participants were selected, based on quota sampling approach, from four educational hospitals affiliated to Urmia University of Medical Sciences, Iran. The final phase involved testing of the revised instrument using exploratory factor analysis. The results showed good CVI (0.89), test–retest correlation coefficient (0.91), internal consistency reliability (0.93), and acceptable face and construct validity. Results of the factor analysis revealed a 6-factor solution, determined by Eigen values greater than 1, accounted for 77.736 of the total variance. This instrument is a simple scale with a good reliability and validity that can provide comprehensive information about the determinants of caring behaviors in a short time.

Episiotomy is used for enlarging the perineum. Aloe vera and Calendula have been used for treating different diseases from ancient times, limited researches have been done regarding the healing of these plants. Since the effect of their ointment on episiotomy healing has not been studied, this study is being done for determining the impact of Aloe vera and Calendula on episiotomy healing in primiparous women. This clinical trial involves 111 qualified primiparous women admitted in Lolagar hospital. They were randomly categorized into three groups of control (n=1) and experimental (n=2) groups. The women in experimental group used Aloe vera and Calendula Ointment every 8 hours and the control group used hospital routine on episiotomy for 5 days. The data were collected by demographic questionnaire and redness, edema, ecchymosis, discharge and approximation scale (REEDA) which investigated the episiotomy healing before and five days after intervention in two groups. ANOVA, Tukey test, Kruskal-wallis, Chi-square were used for data analysis. The three groups do not have statistically significant different regarding demographic and other intervening variables. Comparing the mean of REEDA in five days after delivery showed statistically significant difference between control and experimental groups. According to the results, using Aloe vera and Calendula ointment considerably increases the speed of episiotomy wound healing so it can be used for quickening the episiotomy healing.

Infertility is the problem of 15% of young couples in different societies. One of the factors that could affect fertility is oxidative stress. Therefore، the aim of the present study is to investigate the level of Melatonin، a free radical scavenger، and its correlation with oxidative biomarkers in infertile men. For this purpose، fertile and infertile men in 2 groups، 30 people in each group، were studied. The fertile men were selected from husbands of patients admitted to Alzahra obstetric and gynecology hospital، according to WHO standards. The infertile men were selected from patients referred to infertility ward. Blood sampling from the participants carried out at a specific time، sera collected and the levels of malondialdehyde، total antioxidant capacity and Melatonin were detected in the sera. The data were analyzed using t-test and Sperman''s correlation method. Melatonin level in the sera from fertile men were 522 (39. 32) ng/L and in infertile men were 511. 78 (34. 6) ng/L. MDA level in fertile and infertile men were 2. 26 (0. 34) vs 2. 99 (0. 44) nmol/ml which was significantly different. The level of TAC in the sera from fertile men were significantly higher than in infertile men. The result obtained for correlation coefficient Spearman''s test revealed a significant، strong and direct correlation between Melatonin and TAC and a significant and reverse correlation between melatonin and MDA. It is concluded that melatonin could be involved in infertility. In other word، melatonin treatment and antioxidant-rich nutrition could help fertility by combating oxidative stress.

Despite many advances in the treatment of chronic renal failure, the quality of sleep in patients who suffer from this disease is at the risk. The high prevalence of sleep disorders in hemodialysis patients, which is concomitant with physical, behavioral, and psychological problems, has always affected these patients’ quality of life (QOL). This study aimed to determine the relationship between quality of sleep and quality of life in hemodialysis patients. By using a descriptive and correlational design, this study was conducted on 245 hemodialysis patients in 2012. Patients were selected by convenience sampling from the hemodialysis ward of four training hospitals of Tabriz and Maragheh. Quality of sleep was measured by the Pittsburgh Sleep Quality Index (PSQI), and the quality of life for patients was measured by the Kidney Disease Quality Of Life questionnaire (KDQOL-SF). 83.3% of hemodialysis patients had poor quality of sleep. Poor quality of life was significantly associated with poor quality of sleep. There was a significant negative correlation between global PSQI and important aspects of quality of life including physical health, symptoms and problems, the impact of kidney disease on daily life, burden of kidney disease, mental health, social support, and sexual function. The low quality of sleep in hemodialysis patients has an effect on the deterioration of their quality of life. Therefore, training, counseling, and advocacy programs should be developed to improve the patients’ quality of sleep and quality of life, especially those with lower education level and income, and older people.

The progressive increase in the elderly population of developing countries has drawn attention to their health. Sleep Pattern and quality can affect life quality in old people. We need more documents about footbath (a non-invasive method). The purpose of this research was to examine footbath on sleep quality of the elderly. This study is a blinded, randomized, clinical trial on 46 old men that had health documents in health center, 2013. Participants in the research were divided into two groups. One group had footbath (experimental group) and another group did not have footbath (control group). The experimental group participants were asked to put their feet in warm water (41-42 ºC) for 20 minutes before sleeping for 6 weeks. The co-researcher completed the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention by individual interview. Data were analyzed by SPSS software. The comparison of changes in sleep quality score the old men showed the sleep duration and total sleep quality has significantly improved in the experimental group. According to the study results, the maximum effect of footbath was on sleep latency and sleep duration disturbances. In this study, the researchers had limited access to the elderly in Tabriz; therefore, it is recommended that future research be conducted in a higher number of health centers.

Nursing jobs are among the occupations experiencing high levels of stress. Level of psychological well-being and coping style with stressful situations among nurses has large impact on their job performance. Limited information exists about the relationship between coping styles and psychological well-being among nurses, so the present study examined the way of coping and the level of psychological well-being as well as their relationships among nurses. In this correlational study, 100 nurses from Shahid Sadoughi University of Medical Sciences were selected by multi-stage random sampling in 2012. Lazarus and Folkman''s coping styles and Ryff''s psychological well-being Questionnaires were completed by self-report method. Collected data were entered software SPSS ver. 13 and then analyzed using Pearson correlation test. The results showed EFCSwere more used but PFCSstyle was less used with a little difference by mean (SD) of 87.91 (10.76) vs. 73.12 (12.15). Between EFCSand some psychological well-being dimensions such as purpose in life (P=0.01, r= - 0.28) and personal development (P= 0.03, r= - 0.024), a significant negative association and between PFCSstyle and purpose in life, a significant positive relationship was found (P=0.006, r= 0.31). Considering that PFCSstyle is more effective in solving problems and job stress, as well as, the increased use of EFCSis associated with adverse health consequences, improvement of nurses'' coping strategies to cope better with stressful events by skill training and promotion of nurses'' psychological well-being level is recommended.

Today in all aspects of health care, there is a considerable emphasis on the provision of patient centered care. Various researches in cancer wards have demonstrated that from view of patients, there were some similarities and differences in importance of care in different cultural area. This study aimed to assess what are important for patient centered care in cancer wards. This is a descriptive study conducted with participation of 200 patients with cancer from a cancer center in Tabriz. Convenience sampling was used. The data were collected using Care-Questionnaire, developed by Larson. The Caring behaviors were ordered in 6 dimensions: “Being accessible”, “Explains and facilitates”, “Comforts”, “Anticipates”, “Trusting relationship”, “Monitors and follows through” and ordered on a 5-point Likert-type scale. The data were analyzed using SPSS ver. 13. 0. The results showed that patients with cancer evaluated most of nurses caring behaviors with higher scores (moderate to high) and assigned the “Monitors and follows through” and “Being accessible” as patients’ higher priorities vs the «Comforts» 4. 06 (0. 50) and «Trusting Relationships» as lower priorities. The findings of the present study, indicate that the “Monitors and follows through” and “Being accessible” caring behaviors have more importance by patients with cancer, so these conduces nurses to notice and perform these behaviors in their nursing care. By so doing, moving to the main goal of patient centered care can be provided.

People with epilepsy (PWE) face physical and mental illness, and social stigma, which affect their self-esteem and quality of life. The purpose of this study was to examine the effects of a support group on the self-esteem of PWE. A Quasi-experimental study was performed on 120 PWE in the Epilepsy Clinic at Srinagarind Hospital. The experimental group (N=60) attended the support group before receiving regular health care services. The control group (N=60) received only regular healthcare services. Data was collected by using the Rosenberg self-esteem scale scoring before and after the experiment. The score was analyzed by using a paired t-test and an independent t-test. The study showed that before the experiment, the self–esteem score of the control group was significantly higher than the experimental group. After the experiment, the scores of the control group and the experimental group showed a significant statistical difference. The score in the control group was significantly lower than the experimental group, while the score in the experimental group was significantly higher than before the experiment. The support group improves the self-esteem of PWE. Medical personnel should set up a support group for PWE to enhance their self-esteem.