Evidence Based Care
Volume:5 Issue: 2, 2015

Birth of a premature neonate is associated with hospital admission and separation from the family. Admission of the neonates intervenes on infant-mother attachment and so adversely affects on the quality of care given by the mother, and subsequently increases the risk of delayed behavioral problems in the children.

To assess the effectiveness of mother empowerment program on the premature infant-mother attachment.

In this randomized clinical trial, 70 mothers of premature infants, admitted to the neonatal intensive care unit (NICU) of Omolbanin hospital of Mashhad in 2014, were divided into of intervention and control groups. The Empowerment program was a multi-step treatment program, in which information about the premature infants was provided to mothers through an illustrated booklet with a workbook and audio file in each step. Mothers in the control group received information and routine care according to the hospital guideline. The mother-infant attachment was measured after the intervention using the maternal and neonatal behaviors Avant tool. Data analysis was performed using chi-square and t-student tests by SPSS software version 11.5.

The mean scores of maternal attachment behaviors after the intervention in the empowerment and control groups were (56.62±8.06) and (39.51±7.77), respectively; the difference between the groups was statistically significant (P<0.001).

Our findings revealed that implementation of mother empowerment program increases the mother-premature-infant attachment. Therefore, it is recommended that the empowerment program be routinely utilized to promote the maternal attachment to the premature neonates hospitalized in NICUs.

Self-efficacy is a crucial factor in controlling adolescents with insulin-dependent diabetes mellitus (IDDM). Subsequently the negative behavioral reactions such as aggression adversely affect on self-efficacy. Therefore، interventions are essential to reduce the aggression and to improve the self- efficacy in these patients.

To determine the efficacy of the modified «aggression replacement training» program on self-efficacy of adolescents with insulin-dependent diabetes.

In this clinical trial، 70 adult subjects with IDDM who were referred to Parsian Diabetes clinic of Mashhad in 2014 were divided into two groups of intervention and control. The intervention program، including three aspects including: anger control training، social skills training and moral reasoning training was performed in five sessions، each 1. 5-2 hours. A five-day interval was between the sessions and each group consisted of 8-10 individuals. The self-management standard questionnaire of “insulin-dependent diabetes management self-efficacy scale (IDMSE)” was filled before the intervention and two months afterwards. Data were analyzed using SPSS version 11. 5 with paired and Independent t-tests.

In this study، 38. 5 and 61. 5 percent of the subjects were boys and girls، respectively with total mean age of 15. 9±2. The self-efficacy of the subjects before the intervention was not significantly different within the groups (p=0/57). Nevertheless in post-intervention assessment، the self-efficacy of the Intervention group significantly increased (49. 0±11. 1) compared to the control group (33. 7±5. 5) (p<0. 001).

Our findings revealed the modified aggression replacement training programs can be effective in improving the self-efficacy of adolescents with insulin-dependent diabetes mellitus. Therefore، the implementation of the program is recommended as part of comprehensive treatment programs for management of IDDM.

The most important underlying cause of death in diabetic patients is poor self-care. The effect of education on self-care promotion has been widely investigated; however, the advisory role and impact of the treatment team have been scarcely investigated.

Determining the effect of group counseling on the psychological aspect of self-care and level of glycosylated hemoglobin in the patients with diabetes type II.

In a randomized clinical trial, 73 patients with type II diabetes mellitus, who had been referred to Parsian Diabetes clinic of Mashhad in 2014, were divided into two groups of intervention and control. The group counseling program was performed in five 1.5-hour sessions with 3-day intervals, and each groups consisted of 8 to 10 people. The content of the meetings was problems in nutrition, exercise, diabetes mellitus disease, diabetes-related mental health problems, diabetes medications, and self-control of blood glucose. Researcher-made diabetes care questionnaire was filled and HbA1c test was measured before and two months after the intervention. Data were analyzed by SPSS version 11.5 using paired sample and independent t-tests.

In this study,27.3 percent of the subjects were male and 72.7 were female with the mean age of 49.1 ± 8.3. The scores of physiological aspect of self-care and HbA1C of the diabetic patients before the intervention was not significantly different between the groups; but in the post-intervention phase, the self-care in intervention group (49.1±5.8) significantly increased compared to the control group (31.8±12.2) (p<0.001). In the post-intervention phase, HbA1C in the intervention group significantly decreased (8.3±0.9) compared to the control group (9.1±1.4) (p<0.006).

Group counseling might help to improve the diabetes self-care. Therefore, it can be added to the conventional training programs for better management of this chronic illness.

Studies have shown that mothers of premature newborns have lower physical and psychological quality of life compared to mothers of healthy neonates. Therefore, applying a health promotion program for supporting them is necessary. To determine the effectiveness of a health promotion program on the quality of the life of mothers of premature newborns. In this quasi- experimental study, mothers of premature infants in the neonatal intensive care unit of Milad hospital in 2014 were non-randomly divided into case (45 patients) and control groups (45 patients). Demographic information and Short Form Health Survey (SF36) quality of life questionnaire were collected. The supportive program of the case group was performed in four phases of assessment and recognition, support and the evaluation. Data were collected in three steps: pre-intervention, one and three months after intervention in both groups. Data analysis was conducted by SPSS version 14 using chi-square, independent t and ANOVA statistical tests. Demographic data were similar in both groups (P>0.05). The mean and SD of overall score of quality of life before the intervention was 46.3±9.5 and 48.9±9.5 in the control and case groups, respectively (p=0.1). One month after the intervention, this score was 47.5±6.3 in the control and 57.9±7.05 in the case group (p<0.001). The score of quality of life one and three months, after the intervention, in all aspects, were significantly different between two groups (p<0.05), excluding physical limitations aspect (p=0.4). Thehealth promotion programs are supportive on improving the quality of life of mothers of premature newborns. Therefore, it is recommended that these programs be considered as effective methods for promoting quality life of mothers of premature neonates.

Diaper Rash is a common skin disorder in the infancy that makes infants and their parents anxious and nervous. Due to the high prevalence of dermatitis and its complications in addition to adverse effects of chemical drugs, herbal therapy is an appropriate solution. Comparison of the effects of Chamomile and Calendula ointments on severity of Diaper Rash. This double-blind randomized controlled trial was conducted on 90 infants under one year who were hospitalized in Sabalan Hospital of Ardebil. The infants were treated by Chamomile and Calendula ointments for one week. The severity of dermatitis was evaluated on days one, 3 and 7. In order to assess the severity of dermatitis, the checklist of Diaper Rash five-point scale was used. Data were analyzed by software SPSS version 14 using chi-square, ANOVA, T-Test. The age in the Chamomile group was (8. 8 ± 2.3) and in Calendula group was (9.0± 2.4) months. The severity of dermatitis in Chamomile group before treatment was 1.6 ± 0.5, on the third day 0.8 ± 0.4, and on the seventh day zero (p<0.001). In Calendula group, before treatment was 1.7 ± 0.4, on the third day 1.1 ± 0.4, and on the seventh day zero (p<0.001). The difference between the two groups was significant in mean severity of dermatitis on the third day, so that was significantly lower in the chamomile group (p <0.03). The recovery process in Chamomile was faster than the Calendula. Due to lack of side effects, chamomile ointment can be used as an appropriate treatment in treatment of diaper rash.

Bathing of a premature newborn is important in care giving, but due to inadequate evidences, infant caregivers are not sure about bathing being safe in terms of not causing hypothermia and are not systematically considered in the infants’ care giving programs.

To determine the effect of tub bathing on body temperature of preterm infants”.

This study is a randomized controlled clinical trial which was conducted in 1392 in neonatal unit of Al-zahra hospital. 118 preterm infants were randomly divided into intervention and control groups. The infants in the control group received routine skin care only. The intervention group was bathed three times every other day inside the bathtub. In both group, the infants’ body temperature was measured at the same times by the researcher. Data were analyzed with SPSS software version 14 using independent T-test, Chi-square and repeated measurements tests.

In both groups, boys outnumbered girls. At the time of inclusion, the infant's age was 5.8 ± 8.6 days and their weight was 320.6 ± 1660.0 grams. In both groups, the mean temperature of premature infants after bath was dropped in all three times. Which was statistically significant in the first and second baths (P<0.001). There was no statistically significant differences in temperature changes between two groups in differnet times of measurement (P=0.31).

The results of this study showed that bathing in bathtub does not cause improper body temperature changes in preterm infants. It is recommended that this correct bathing method should be used in the care giving program of the infants hospitalized in neonate's wards and Neonatal Intensive Care Units.

Depression, anxiety and stress are common among hemodialysis patients affecting their mental health and quality of life, leading to multiple dysfunctions. Anti-anxiety effects of aromatherapy, as one of the domains of complementary medicine, have been investigated in several studies. Investigation of the effect of aromatherapy with lavender essential oil on depression, anxiety and stress rates in hemodialysis patients. This study was a randomized controlled clinical trial performed on 60 patients undergoing hemodialysis in Tehran, Iran in 2014. The patients were randomly divided into intervention and control groups. To measure the rate of depression, anxiety and stress, the Depression Anxiety Stress Scales-21 was used. In the intervention group, the patients were asked to inhale the lavender essential oil smeared on a piece of cloth (three drops of oil) for one hour during the hemodialysis procedure. After 4 weeks, the rates of depression, anxiety and stress were re-measured. Data analysis was performed by SPSS software version 14 using chi-square, Wilcoxon and Mann-Whitney U statistical tests. In this study, 33(60%) of the participants were male, and 53(96.4%) were married. After the intervention, the scores of depression (P<0.001) and stress (P<0.04) significantly decreased in the intervention group in comparison with control group; but the reduction in the anxiety score was not statistically significant. Aromatherapy with lavender essential oil might reduce depression and stress among hemodialysis patients. Therefore, this method can be used as a complementary method with less complication to improve the quality of life of these patients.

Premenstrual syndrome (PMS) is consisted of multiple psychological and emotional symptoms. This disorder possesses adverse effects on women’ economic, social, familial and professional issues, therefore various medical therapies have been suggested, thus all have own side effects. To compare the effects of relaxation and vitamin B6 on emotional and physical symptoms of PMS. This is a randomized clinical trial study with pre- and post-test design. The study was conducted on 150 girls living in public dormitory whom were randomly divided into three groups. The relaxation group trained in two sessions and then one week before menstruation, the taught techniques were carried out on a daily basis. The second group received 80mg vitamin B6 tablets QD for one week before menstruation and then three times a week for one cycle. The third group received no intervention as control group. Each day, data were collected using a researcher-made questionnaire and where analyzed using SPSS version 14 with paired T and ANOVA tests. The mean age of the participants was 20.6±1.5 and their average weight was 54.1± 6.6. The mean scores of psychological symptoms after the interventionwere 1.2± 0.2 in vitamin B6 group, 0.3± 0.7 in relaxation group, and 1.6 ± 0.4 in the control group (p<0.001). Vitamin B6 and relaxation were both effective in reducing the psychological symptoms and this change was more prominent in the psychiatric symptoms in the relaxation group. The mean score of physical symptoms before the intervention, showed significant difference among the groups (p<0.01); and after the intervention it was 0.8±0.2 in vitamin B6, 1.6±0.3 in the relaxation group, and 1.0±0.5 in the control group (P<0.001). Paired t-test showed significant difference in the scores before and after the intervention, within the vitamin B6 group (p<0.001); just vitamin B6 was effective in reduction of the physical symptoms of PMS. Relaxation and vitamin B6 both are effective in reducing the psychological symptoms of PMS; but vitamin B6 is more efficient in alleviating of the physical symptoms compared with relaxation.