Iranian Journal Of Medical - Surgical Nursing
Volume:4 Issue: 1, 2015

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease. Addition to various clinical manifestations it has spiritual، psycho-social and economic consequences. The present research was conducted aimed to describe the lived experiences of patients living with systemic lupus erythematosus. A qualitative study، using phenomenology approach was used. Ten patients with SLE who referred to rheumatology clinic in Bandar Abbas were selected through purposive sampling in 2012. Data generation was done through in-depth unstructured interview. Colaizzi''s method of data analysis was used for analysis. The results of study demonstrated four main themes including Mental-emotional consequences، pain of recurrence of disease، forgotten socio-economic needs and inability to perform duties. According to results، patients experience the wide range of problems and they need to take care of family and society concerning the physical aspects and receiving psychological support in psychological aspects. Because of the medical expenses and work-related disability، economic pressures propel them to dependence and challenge in meeting the needs of health care. Some of their needs remain unanswered

Intravenous injection is one of the most common painful invasive procedures in hospitalized children. This study was conducted aimed to determine the effectiveness of using anesthesia evaporative spray on pain intensity associated with intravenous injection in hospitalized children. In this clinical trial study 60 children between 6-12 years old who were hospitalized in Imam Reza Hospital in Sirjan in 2014 were studied. They were selected through convenience sampling and then were randomly assigned into two groups of 30 people. In the intervention group، anesthetic spray evaporation was used 30-40 seconds before intravenous injection and in the control group، the similar spray but containing saline was used. Pain intensity was assessed during the intervention through using the behavioral scale and immediately after the intervention by the visual analog scale. Data analysis was done through SPSS 19 and using central and dispersion indexes and independent t-test. The children in intervention group reported less pain intensity than control group in both scales. The mean score of behavioral pain scale and VAS in intervention group was respectively 3. 4 ± 1. 85 (p = 0. 002) and 3. 96 ± 2. 39 (p = 0. 036). According to results، using the anesthesia evaporative spray can reduce the pain associated with injection procedures in children. Therefore; it is recommended that the evaporative spray used before the intravenous injection in children.

Acute coronary syndrome as one of the leading causes of death in the world، have several physical، psychological and social consequences. These consequences have impact on quality of life and sexual satisfaction of patients. Despite numerous studies، contradictory findings have been reported concerning the relationship between sexual satisfaction and quality of life in these patients. The current study was conducted aimed to determine the relationship between sexual satisfaction and quality of life in patients with acute coronary syndrome. This Descriptive-correlational study was performed on patients with acute coronary syndrome hospitalized in the coronary angiography ward in a hospital in Kashan University of Medical Sciences in 2014. Three hundred patients were selected and entered into the study through purposive sampling. Data collection was done through using the demographic and clinical data questionnaire، SF-36 quality of life questionnaire and Larson''s sexual satisfaction questionnaire. Data were analyzed using SPSS 13 and central indexes، independent T-test، analysis of variance، Pearson correlation test and linear regression analysis. Patients had high sexual satisfaction (101. 19 ± 15. 02) and average quality of life (56. 3 ± 17. 15). There was significant positive correlation between sexual satisfaction of patients with quality of life (P = 0. 001)، it’s physical (P = 0. 018) and psychological (P = 0. 001) aspects. There is relationship between sexual satisfaction with the quality of life in patients with acute coronary syndrome، therefore; it is recommended that nurses must pay attention to education concerning the sexual relationship and physical and psychological support in patients with low rejection fraction.

The ultimate goal of treatment of patients in intensive care unit is increasing their level of consciousness. The present study was conducted aimed to determine the effect of sedation protocol on level of consciousness in ventilator-dependent trauma patients who hospitalized in intensive care unit. This quasi-experimental study was conducted on 80 patients undergoing mechanical ventilation in intensive care units (ICU) of selected hospitals in Zahedan in 2013. At first، patients were selected through purposive sampling and then randomly allocated into intervention and control groups. Patients in intervention group received the sedation protocol proposed by Society of Critical Care Medicine. Data were gathered through Richmond-Agitation Sedation Scale، behavioral pain scale and Glasgow Coma Scale. Data were analyzed in SPSS 18 through using the independent t-tests. Level of patient’s sedation was near to ideal score for Richmond in intervention group in compare with the patients in control group (-1 to +1). There was significant difference between two groups regarding the relaxation of patients (p<0. 001). Also، the level of consciousness in patients has significant increase in intervention group in compare with control group (p=0. 02) The results showed that the use of sedation protocol can increase the level of consciousness in the hospitalized patients in intensive care unit. Thus، it is recommended that this protocol was used by nurses.

Chronic renal failure can eventually lead to various complications such as impaired sleep quality of patient، so; the adequacy of dialysis in these patients is very important. This study was done aimed to determine the effect of continuous care model on sleep quality and dialysis adequacy of hemodialysis patients in Jahrom. In this clinical trial study، 40 patients in hemodialysis ward were selected through simple random sampling in Motahari Hospital in Jahrom in 2013. To survey the quality of sleep، the Pittsburg Sleep Quality Index and to measure the adequacy of dialysis، the formula kt/v was used. For applying the continuous care model، patients were divided into 5 groups and for each group، 4 to 6 training sessions were held during the 4 weeks. Sleep quality and dialysis adequacy were measured during four stages; 1 month and immediately before intervention، immediately and 1 month after intervention. Data analysis was done through SPSS16 and using the independent t-test، repeated measures analysis and Pearson’s correlation coefficient. The mean score of sleep quality was significantly higher before the intervention (9. 96±1. 87) in compare to after (9. 07±2. 19) the intervention (p=0. 002). Also; the mean score of dialysis adequacy was improved immediately after the intervention (1. 13± 0. 3)، but it decreased again one month (0. 97±0. 31) after the intervention (p=0. 034). The implementing of continuous care model caused an improvement in sleep quality، but there was no positive effect on dialysis adequacy. It is recommended that the nurses implement this model in caring of other patients through doing further research in this area.

Tracheostomy is one of the most common surgical procedures in intensive care unit. Although the implementation of standard care can lead to decrease the postoperative complications، but some factors causes the negative attitude in nurses and consequently lead to implementing the routine and non-standard care. The current study was conducted aimed to determine the level of observing standard tracheostomy care and some barriers from perspective of nurses. In this descriptive-analytical study 42 nurses who were working in two selected hospitals in Tehran in 2013 were entered the study through census. Data were gathered through researcher made questionnaire for demographic data، observation checklist for standard tracheopstomy care and its barriers. The researcher observed 3 times concerning the how to care of tracheostomy by nurses and then nurses completed the demographic and barriers to standard care questionnaires. Data were analyzed by SPSS 21using one sample T-test، independent T-test، chi-square، ANOVA and Pearsons’ correlation coefficient. According to results، only 2 nurses (4. 8 percent) performed the standard tracheostomy care. The Most barriers affecting on the standard tracheostomy care were the administrative barriers (54. 76 percent). Also، there was a moderate positive correlation between standard care with administrative barriers (r=0. 46، p=0. 002)، personal barriers (r=0. 38، p=0. 012) and all of the barriers (r= 0. 46، p=0. 002). Most tracheostomy care are not according to standard protocols and most important barriers of its implementation are administrative barriers. With attention to the importance of this care، some necessary measures must be taken to resolve the barriers.

Proper nutritional support is one of the important caring aspects in patients who were hospitalized in Intensive Care Unit. Although the several studies have been done concerning the selection of proper nutrition method for patients، but there is no agreement on this issue. The aim of current study was the compare the effect of two ways of tube feeding including bolus and continuous infusion on gastric residual volume and diarrhea in patients hospitalized in Intensive Care Unit. The current clinical trial was conducted on patients who were hospitalized in intensive care unit in Alzahra hospital in Isfahan، 2013. Fifty patients were selected through convenient sampling and were randomly assigned into two groups of 25 people of intervention and control. Nutrition was done through infusion pump in intervention group and by bolus in control group. Gastric residual volume and diarrhea was assessed each four hours for four days. Data were gathered through checklist and were analyzed by SPSS18 using descriptive and inferential statistics including independent T-test، Fisher''s exact test and repeated measures ANOVA. The results showed that the mean of gastric residual volume in control group was more than the intervention group on the third day (p=0. 04). Also، the mean of gastric residual volume did not show significant difference at different times in intervention group، but the mean of gastric residual volume was significantly increased in control group at different times (p=0. 04). Fisher''s exact test showed no significant difference between two groups concerning the diarrhea frequency. In nutritional support with continuous infusion method، gastric residual volume was not increased and gastric emptying rate was not diminished. Therefore، this method can be used as an appropriate nutritional support in intensive care unit.

Spinal cord injury as a debilitating disorder has multiple physical and psychological consequences and can affect on the ability to perform daily activities and all indexes of quality of life. The aim of present study was to determine the effect of wives group training on activities of daily living and quality of life in male patients with spinal cord injury. In this quasi-experimental study، 60 patients with spinal cord injury and their wives were purposively selected and then were randomly allocated into two intervention and control groups. Data collection tools including quality of life questionnaire (SF-36) and Barthel index of activities of daily living. Wives of male patients in intervention group participated in 6 group sessions of educational program. Data analysis was done through SPSS 21 and using paired T-test and multivariate analysis of covariance. Results showed that the wives training caused improvement in quality of life of patients with spinal cord injury in physical aspect (38. 085. 14، p=0. 001) and psychological aspect (60. 338. 38، p=0. 001). It also improved the ability of patients in daily activities (44. 1613. 92، p= 0. 01). According to chronic nature of spinal cord injury، participation of patients’ wives in educational programs can cause improvement in their quality of life and daily activities. Therefore; it is recommended to participate them in care plan through training.