Iranian Journal Of Medical - Surgical Nursing
Volume:2 Issue: 1, 2013

Kidney transplantation is considered as selective and the most effective alternative way in treatment of patients with end-stage renal disease. Transplantation may improve patients'' life quality، but it can also lead patients to face new challenges and concerns. Since there is little information about coping process of patients with renal transplantation، understanding how they cope with transplanted kidney may help health care providers to plan and implement appropriative and holistic care. The aim of this study was to explore the coping process in renal transplant recipients. A qualitative method with grounded theory approach was used to explore renal transplantation coping process. First، participants were purposively selected among renal transplant recipients and gradually continued with theoretical sampling. 11 renal transplant recipients in Afzalipour hospital، Kerman، Iran، and 3 family members were interviewed (n = 14) during 2011-2012. Data analyzing was done followed guidelines proposed by Strauss and Corbin (1998). Three categories emerged from data analysis including «perceive reality of transplantation»، «coping strategies» and «learning challenging life». Results demonstrated transplanted kidney coping as a calm and steady process with special characteristics in each step. The main theme emerged from the text was continuous and purposive struggling to reach calmness in new life. Understanding the reality of transplantation and its challenges have temporarily and permanently effects on patient’s life. In this process، nurses as important members of health care team can provide appropriate educational programs and supportive care in order to assist patients to learn how to cope with transplanted kidney and its challenges.

Sleep disturbance can negatively affect the quality of life of older adults. Nowadays، complementary and alternative medicine is commonly used to treat insomnia in old aged ones. The aim of the present study was to determine the effect of reflexology on improvement of sleep quality in elderly. This was a single-blind controlled clinical trial on 46 men at the age of 65-70 years in Tabriz، Iran. Participants were randomly divided into two equal groups. One group received reflexology (intervention) and the other did not (control). The intervention was performed for each leg once a week in the mornings and for 10 minutes. The study measurement tool was the Pittsburgh Sleep Quality Index completed before and after the intervention by the researcher assistant. Data were analyzed using Wilcoxon and Mann-Whitney tests. There was no significant statistic difference among the questionnaire components except for “sleep duration” (P = 0. 010) between the two groups. Comparing pre- and post-intervention scores، the differences between two items of the questionnaire، “subjective quality of sleep” (P = 0. 029) and “delayed sleep phase” (P = 0. 001)، were statistically significant. According to the study results، the maximum effect of the intervention was on subjective sleep quality and sleep duration disorders. We faced limited access to the elderly in all areas of Tabriz; therefore، study could be conducted in health centers in future research.

cardiovascular diseases are the most common causes of death all around the world. Regarding to the critical role of the cardiovascular system، its'' physical examination is a key component of nursing skills which plays an important role in determining the health and problems of the cardiovascular system and designing an appropriate nursing care plan. Evaluating the skills of health care providers is important to ensure the quality of care. This study was aimed to assess the nurses'' self-assessment skills about cardiovascular physical examination. This cross-sectional study was conducted on 200 nurses working in Isfahan province hospitals in the first two months of 2013. Data was collected by a researcher made questionnaire including two parts: the first part was included demographic data and the second part was included 18 skills in cardiovascular physical examination in two different columns. In the first column، the frequency of using skills، and in the second column، the level of their proficiency was self-assessed by nurses. Statistical analysis was conducted through ANOVA and independent T tests in SPSS software، version 11. 5. The findings showed that most and the least used skills by nurses to assess cardiovascular system were heart rate and Trendelenburg test، respectively. Also، the highest level of proficiency of the nurses were in assessing heart rate; and the lowest level of proficiency was in assessing Hepatojugular reflex and Trendelenburg test. In total the skills of cardiovascular physical examination in nurses was lower than desirable. the level of proficiency in the skills of cardiovascular physical examination and their application in clinical settings in nurses was not reported satisfactory، regarding that the examination of this system has a vital role in the patients'' health، and this issue needs special training measures.

Anxiety influences the patient''s physiological reactions and makes him/her in danger in angiography room. The purpose of this study was to determine the impact of aromatherapy on the hemodynamic condition of patients experiencing coronary angiography. This clinical trial study was performed on a group of 96 patients hospitalized in Sari Fatemeh-Zahra hospital، Iran، for coronary angiography. They were selected by convenience sampling and randomly devided in two control (46) and experimental (45) groups. The two groups in terms of gender، marital status، educational level، history of disease، age and having health insurance were matched. The collecting data tools consisted of demographic questionnaire and hemodynamic variables recording sheet، measured by blood pressure gauge and chronometer، filled out for both groups before and after aromatherapy. The collected data were analyzed using chi-square t، and repeated-measures ANOVA tests. The systolic blood pressure variable، pulse and respiration rate reduced meaningfully after the aromatherapy in experimental group compared to controls. Despite no significant differences between the groups among other variables، their clinical condition often showed better in experimental group. According to our findings، we suggest that using aromatherapy before stressful situations like diagnostic technics helps to reduce vital signs and maintain it in normal range.

Patients under hemodialysis treatment face various physical and spiritual problems. Since individual''s compatibility in hard conditions of life increases with high self-efficacy، this study aimed to determine the effect of quality of life training on self-efficacy in patients under hemodialysis treatment. In this research clinical trial study، the Sample contained 90 patients under hemodialysis treatment (45 ones in each group) selected randomly among patients referred to dialysis centers of Kerman city، Iran. Data collection devices consisted of demographic questionnaire، SUPPH (Strategies Used by Patients to Promote Health) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) instrument which were categorized to 3 levels، high، medium and low. Both groups were pretested. In intervention group، quality of life training program was implemented in the forms of speech، question and answer and giving pedagogic pamphlets during 3 sessions of 45-minutes between which، there were 10 days of interval. Control group did not received any training about quality of life and and self-efficacy issues. 2 months after the first test، second test was conducted for both groups. The data were analyzed using chi-square، paired and independent t tests. There was no significant difference in quality of life and self-efficacy between the two groups before training. Nevertheless، after training، the quality of life (P = 0. 001) and self-efficacy (P = 0. 001) increased in intervention group. This research shows that quality of life training program affects self-efficacy of patients under hemodialysis treatment. So، it is recommended that quality of life training programs become a part cares provided by hemodialysis centers.

Skin to skin continuous contact between mother and neonate، induced by the first breastfeeding، is the fourth of the ten steps for successful breastfeeding during one to two hour of birth that lead to express early breastfeeding behaviors. The present study aimed to evaluate the effect of two methods of crawl and routine breastfeeding on behavior of breastfeeding during two hours after delivery. In this randomized clinical trial (RCT)، 60 women with term and singleton pregnancy and without episiotomy in temperature of birth room (23-25 C) were enrolled in Imam Ali hospital، Zahedan، Iran، during 2009-2011. Participants were selected by purposive sampling and were randomly divided in two groups of crawl and routine breastfeeding. In crawl group، the neonate immediately after birth (before all of interventions) lied on mother''s skin between breasts and abdomen for 60 minutes to start breast crawl without helping. In routine group، the neonate only lied on mother''s skin between breasts and abdomen for 15 minutes. Then، in both groups the neonate was wrapped and closed to mother to be breastfed under the nurse supervision. During this time، 6 items of expository early movement and 4 items of successful breastfeeding behavior were evaluated using infant breastfeeding assessment tool (IBFAT) scale; mother''s satisfaction of skin contact with neonate was recorded according to numeric scale (0-5). 4 successful breastfeeding behavior items (P < 0. 001)، and four expository early movement items (P < 0. 001) were significantly better in crawl group. Skin sense satisfaction was significantly higher in crawl (4. 37 ± 0. 62) versus routine (1. 93 ± 0. 85) group. According to our findings، crawl method was more effective in promoting breastfeeding behavior during two hours after delivery. Regarding young mothers'' satisfaction، this method can be recommended to promote successful breastfeeding.

Coronary artery bypass graft (CABG) surgery is one of the treatment methods for heart diseases developed recently. Due to increase in the number of patients undergoing this surgery and the enormous costs، surving its effects is necessary. Assessing quality of life in patients undergoing coronary artery bypass graft surgery can help us for determining its effects. In this prospective study، 60 patients who were candidate for undergoing coronary artery bypass graft surgery were selected by purposful method from Emam Khomeini hospital in Uremia، Iran، during 2009-2010. Quality of life in patients in three parts of physical، social and psychological domains was evaluated before surgery and six months and one year after it by a researcher-made questionnaire. The gathered data were analyzed using ANOVA and t tests. The patients'' quality of life in all three domains was at intermediate level. Comprising patients’ quality of life in three times showed statistically significant improvement in physical (P = 0. 002) and psychological (p<0/001) domains without any advance in social dimension (P = 0. 680). Overall quality of life become better during the study (P = 0. 004). To improve quality of life in patients undergoing coronary artery bypass graft surgery، providing facilities such as rehabilitation programs and long-term follow-up is necessary.

Introduction and Burn wound is of the health problems in modern societies associated with irreparable harms and many side problems for patients and their families. Pain is one of the primary results of the burn wound and pain relief is a basic need and right of all patients. This study aimed to evaluate and compare the effect of palliative dressing with silver sulfadiazine 1% cream and fundermol herbal ointment. In this clinical trial study in 2010، using convenient and continuous sampling method، 50 patients referred to Imam Mousa Kazem Burn Injury Clinic in Isfahan، Iran، with second-degree burn wounds were enrolled. The patients were randomly divided into two groups of treatment with dressing with fundermol or sulfadiazine. Pain intensity was measured using a standard visual analog scale (VAS). The data analysis consisted of descriptive and inferential statistics USING chi-square، Mann-Whitney، and Wilcoxon tests. In the group treated with fundermol، the pain intensity significant decreased after the treatment (2. 87 ± 0. 39) compared to before (4. 87 ± 0. 25) it (P < 0. 001). But، in silver sulfadiazine 1% group، the pain intensity did not differ statistically after the treatment (4. 88 ± 0. 26) compared to before (5. 01 ± 0. 19) it (P = 0. 213). Post-treatment pain intensity difference between the two groups was statistically significant (P = 0. 001). According to the results، using the fundermol herbal ointment to cure and relieve the pain of second-degree burns is recommended.

Introduction and

Hemodialysis is the most common renal replacement therapy in patients with end-stage renal disease. Although this method increases survival rate and life expectancy، but this patients face with many problems such as sleep disorder and restless legs syndrome. The present study was carried out to investigate the relationship of restless legs syndrome and sleep quality among hemodialysis patients.

In this case-control study، 74 hemodialysis patients with sleep disorders (cases) were selected by convenience sampling method and matched with 74 hemodialysis patients without sleep disorders (control) in sex and age (± 5). Then، restless legs syndrome and its severity were compared in the both groups. The data collection instruments included demographic information questionnaire، four criteria for restless leg syndrome based on the International Restless Legs Syndrome Study Group، and Pittsburgh Sleep Quality Index. Data were analyzed by independent t and chi-square tests.

Totally، 37. 8% of hemodialysis patients showed signs of restless legs syndrome. 54. 1% of cases and 21. 6% of control suffered from restless legs syndrome. The restless legs syndrome incidence was 4. 26 fold higher in patients with than those without sleep disorders (CI95% = 2. 08-8. 74، OR = 4. 26).

Given to the relationship of restless legs syndrome and sleep disturbance، restless legs syndrome screening in hemodialysis patients seems necessary.