Evidence Based Care
Volume:3 Issue: 2, 2013

Nurses constitute the largest group of health care providers and play a fundamental role in continuing of care and health promotion and preservation at different levels of the health provider system. After new change in the health care system، society expects more from nurses. Researchers believe that in order to elevate the quality of nursing care، acting based on the evidence and research is necessary، therefore، nursing care will be more useful and efficient. This study aimed at the determination of the implementation rate of evidence-based nursing cares by nurses in State Hospitals in Ahwaz. In this descriptive-correlative study، 484 nurses working in the State hospitals in Ahwaz were included with the proper sampling method. A questionnaire was used to gather complete information. ~This study was supported and approved by related specialist. The first part included the demographic characteristics of the responders، and the second part was related to the implementation rate of evidence based nursing care. The information was analyzed by SPSS 17. The results show that majority of responders (53%) were at a poor level in implementation of evidence-based nursing car. There was not any significant relation between age، experience of work، gender، type of employment، professional states، shifts of the studied sections and implementation of evidence-based nursing care (p> 0. 05)، however، there was a significant relation between the material status، educational rate of interest in the job and rate of the implementation of evidence-based nursing care (p< 0. 05). Since the majority of studied sections do not have evidence-based nursing practice، there is an urgent need for the comprehensive effort of nurse’s community and organizational support to achieve nurses’ move towards providing evidence-based nursing care.

Thalassemia is the most common hereditary disease in Iran. Cardiac complications and cardiac symptom have been identified as the major problem، which has profound impact on the mental health of patients with thalassemia. One method of reducing this impact is an exercise plan. The purpose of this study was to examine the effect of a designed Walking plan on the mental health and functional ability and cardiac symptoms in patients with thalassemia. In a semi-experimental study، 75 patients with thalassemia major (18 years and older) were randomly divided into the case and control groups. The patients in case group sas carried out the designed walking plan for eight weeks. At the beginning and end of the program mental health measured by (Goldberg) Questionnaire، functional ability measured by 6MWT. Cardiac symptoms were measured every week by Cardiac symptoms questionnaire. Validity and reliability of the questionnaire was assessed by content validity and test-retest reliability with (α=0. 96). Data were analyzed using SPSS 16 software. Chi-square and paired and Independent T-test and Repeated Measure ANOVA were performed. There was no significant difference between two groups in demographic variables. The post mean of mental health in case group (39/72±6. 27) was lower than the control group (54/67±6. 03) and this difference of mean mental health between two groups was significant (p=0. 001). Mean of distance 6MWT in case group (440/65±103. 46 M)، was more than the control group (395/50±90. 25 M) and the mean distance 6MWT between two groups was also significant (p=0. 04). Repeated measures analysis of variance of cardiac symptoms scores have shown that there is a significant difference from the viewpoint of change pattern of mean Cardiac symptoms score in eight weeks between two groups (p=0. 001). Implement designed walking program improve the mental health، functional ability and reduces cardiac symptoms. This program is recommended to all patients with thalassemia.

Diabetes control needs more effective educational programs. Self-care education is an important factor in diabetes control. It seems that the symptoms can be the proper stimulus for the direction toward self-care. To evaluate the effects of the using SFMM on HbA1c، knowledge، self care practices، and symptoms of type2 diabetic patients. Seventy type 2 diabetic patients were randomly assigned to the intervention and control groups. Data was assessed using four-part questionnaire، diabetic knowledge، self-care practices and symptoms of patients. HbA1c was also measured. The subjects in the intervention group received 3-4 individual educational sessions، which lasted 60-90 minutes. The educational sessions were focused on the self-management behaviors. The subjects in the control group received routine educations. After 3 months، the above mentioned variables were measured again. Data was analyzed with SPSS 15. 0 and STATA using paired T-tests، GLM، fisher-test، and covariance. The finding presented in this study showed a decrease in HbA1c levels in the experimental group، however، this decrease did not reach statistical significance (P=0/06). There was a significant increase in the knowledge of diabetes (P<0/001) and self-care practices such as diet (P=0/02). The intervention group experienced a decrease in hyperglycemia and hypoglycemia symptoms (P=0/02، nP=0/02). However، no statistical differences were observed in foot-care (P=0/56)، physical activity (P=0/3)، blood glucose control (P=0/4)، and medication (P=0/35) self-care practices. The differences in frequency of sensational symptoms (P=0/33)، and other symptoms of patients between two groups were not significant (P=0/12). The results showed that application of this model (SFMM) is effective in the education of type 2 diabetes. In addition، this model suggested the need for designing educational programs.

Anxious disorders are very common psychiatry problems in pregnant women. Today، in addition to the conventional medicine، complementary medicine (acupressure and cupping therapy) is also important in the treatment of painful syndromes. The aim of this study was to determine the effect of dry cupping and acupressure application on postpartum anxiety in nulliparous women admitted to the Central Selection Shiraz (Hafez). In this clinical trial، 150 patients with collected with purposive sampling was recruited from the University Hospital of Hafez in 2012. Cupping therapy was performed four times a week for 20-15 minutes each time and also Acupressure within 20 minutes، according to the circular model. Spiel Berger State-Trait Anxiety Inventory was completed and data was analyzed by the SPSS statistical software (version 16) and a repeated measure ANOVA was performed. Mean postpartum anxiety in the cupping therapy group was 47. 1 ± 5. 8 at baseline visit and decreased to 42. 4 ± 4. 6 after the intervention. The difference between the intervention and control groups was statistically significant (P = 0. 01) and in Acupressure group decreased from value of 46. 8± 4. 7 to 46. 6 ± 4. 4 after the intervention. However، this value was increased from 46. 0± 5. 2 to 50. 2 ± 4. 9 after the intervention in the control group. The results showed that postpartum anxiety، decreased in both interventional groups but in the cupping experimental group، the reduction was significant. Therefore، it is used as an effective treatment in reducing anxiety after childbirth.

Iran is one of the regions with high incidence of premature births، accounting for 10% of newborns. An important factor for the survival chance of the neonate is age. This study investigated the effect of massage on premature infant’s complications in the neonatal intensive care unit (NICU) of Ghaem Hospital in Mashhad. This study was conducted on 60 stable preterm newborns. Intervention was included passive massage movements on members and a daily intervention for three periods of fifteen minutes in 3 hours until 5 days. 30 newborns in an intervention group (mean gestational age of 32. 8 weeks and mean birth weight of 1525. 5gm g) were compared with 30 newborns in the control group (mean gestational age of 31. 6 weeks and mean birth weight 1321 gm). The study showed that the apnea and feeding intolerance in experimental group was significantly less than the control group P≥ 0/001. Our findings show that massage is an effective method for reducing the complications in stable premature.

Dyslipidemia is one of the major causes of the production and progression of atherosclerosis in hemodialysis patients. Vitamin C is able to improve dyslipidemia by reducing an oxidative stress. The aim of this study was to evaluate the effect of vitamin C supplementation on dyslipidemia in hemodialysis patients. In a randomized، double-blind clinical trial، 160 patients with chronic renal failure were studied. They were divided into three groups (intervention، control and witness). In an intervention group، 250 mg from vitamin C was injected، three times weakly at the end of each dialysis session via the intravenous route، for 8 weeks. In the control group same amount of placebo saline was injected and in the witness group no intervention was performed. Required laboratory parameters including serum total cholestrole، triglyserid and HDL were measured at the beginning and end of the intervention. In order to analyze the data، SPSS statistical software was used، and test Chi square and ANOVA were performed. P value less than 0. 05 is considered statistical significance. No significant differences were observed in the serum levels of cholesterol، triglyceride and HDL between groups before and after the intervention. The results of this study demonstrated that 250 mg intravenous vitamin C did not change serum levels of cholesterol، triglyceride and HDL.

Chronic renal failure is a life-threatening condition; patients due to the prolonged stress are very susceptible to mental health problems. Dignity therapy is a novel therapeutic approach to the treatment of psychological problems for patients who suffer from life-threatening illnesses. This study examined the impact of dignity therapy on human dignity in patients undergoing hemodialysis. This is a two-group experimental research with pre and post tests design، which was conducted on selected hospitals of Mashhad in 139. From 74 patients recruited for the study; 36 patients of even days were assigned in intervention group and 38 patients of the odd days were assigned to be the control group. In the intervention group، during the hemodialysis، dignity therapy has been performed in 3-4 sessions. Human dignity was examined before and one month after the intervention by Patient Dignity Inventory، and collected data were analyzed by using statistical tests. The mean age of subjects in this study was 49. 0±12. 8 years (20-70 years). The most of patient were married (44. 6%) and had primary education (81. 1%). Results showed the mean scores of Human dignity in intervention group in the pretest (47. 2±15. 3)، and posttest (40. 4±18. 35)، were significantly different (P=0. 001)، while this change in control group did not reach statistical significance (P=0. 572) By planning and performing such interventions، the dignity level in chronic renal failure patients may be increased.

Infancy is the most important extra uterine period of brain development. And it requires environmental stimulation for expression of the developmental capabilities. Meanwhile، due to repeated environmental disparities foster care children are at risk for developmental delay. designing evidence based care package to improve motor skills of orphan living infants according to integrative review approach. In this integrative review after problem identification، search was made with a combination of assigned index (MESH) terms and text words including Motor development، Infant، Stimulation، Intervention، Improvement، Environment between May 2012 to May 2013 and research span of 1970 to 2013، in the following databases: The Cochrane Central Register of Controlled Trials، AMED، CINAHL، EMBASE، Ovid MEDLINE، MEDLINE Advanced، PsycINFO، Google scholar. After the final selection based on the inclusion and exclusion criteria، articles were translated، data were collected using a data collection form، and analysis/ coding were done according to constant comparative analysis method. Then the findings were combined and edited according to the assigned codes، until the various components of the package have been appeared and completed. Of the 180 citations، 141 citations were excluded due to lack of the necessary criteria and the data obtained from the 39 citations including appropriate toys، skills، child-care givers interactions، care practices and environments to stimulate motor development، were been integrated to made an evidence-based care package to promote motor development of orphan living infants. Evidence-based care programs could be achieved، with incorporating rich information obtained from the studies of infant development، in the form of high-quality review studies. Providing similar packages for other communities and areas of development is proposed.