Preventive Care in Nursing & Midwifery Journal
Volume:5 Issue: 1, 2015

Aspiration is a serious complication that occurs due to delayed gastric emptying in mechanically ventilated patients. Aspiration results in increased rate of pneumonia and death. Acupressure can increase gastric motility and prevent aspiration. This study aimed to determine the effect of acupressure on occurrence of gastric content aspiration in mechanically ventilated patients hospitalized in intensive care units. In this quasi-experimental study، 78 patients hospitalized in the intensive care units of educational hospitals of Zanjan were recruited using convenience sampling method during 2012-2013. Patients were randomly allocated into two intervention and control groups. In the intervention group، acupressure wristbands were placed on the Neiguan point of both hands of the patients for four days. Aspiration was measured and compared using glucose and PH strips on the second and fourth days in both groups. Data were analyzed using the independent T-test، Mann-Whitney، Chi-squared test، Mantel-Haenszel and logistic regression in the SPSS-16. The aspiration، totally and in the fourth day، was lower in the intervention group in compare with the control group; however the difference between the two groups was not statistically significant. Acupressure is an easy-to-use and harmless method to relatively decrease aspiration among the patients. It can be considered as a complementary treatment in decreasing aspiration among patients hospitalized in the intensive care units.

Stress is a common and important psychological problem among patients undergoing hemodialysis. Stress can negatively affect the quality of life, treatment acceptance, and disease progress in patients. Participation of patient in self-care activities lead to more independence and patients adjustments with their illnesses. The aim of this study was to determine the effect of a self-care educational program based on the Orem's model on stress in hemodialysis patients. This semi-experimental pretest-posttest study was conducted in the educational hospitals affiliated to Zanjan University of Medical Sciences. Participants were selected among from patients undergoing hemodialysis through convenience method; and were allocated into two intervention and control groups using blocked randomization. After baseline measurement, the educational program was implemented in the intervention group for 30-minutes weekly sessions. Stress was measured before and one month after the intervention in both groups using the stress part of the DASS-42 questionnaire. The data were analyzed in the SPSS-19 using descriptive statistics, paired-t test, independent t-test, and chi-squared test. The mean age of the participants was 55.13±15.1 years. Most of the participants were male (63.3%), 76.0% were married; and 47.88% had not finished the high school. There was a significant decrease in the mean stress score after the intervention (P<0.001). There was also a significant difference in the mean of stress score between the two groups after the intervention (p=0.03). According to the positive effect of our educational program designed based on the Orem's self-care model, it seems that the program could be implemented to decrease stress in patients undergoing hemodialysis.

Cough and dyspnea are two most common symptoms in chronic obstructive pulmonary disease patients. The aim of this study was to investigate the effect of pulmonary rehabilitation program on severity of symptoms in patients with chronic obstructive pulmonary disease. This study was a clinical trial in which 70 patients with mild and moderate chronic obstructive pulmonary disease were recruited from an outpatient clinic and were randomly divided into two experimental and control groups. The control group received routine visits. The experimental group patients participated in the pulmonary rehabilitation program. They were also encouraged to practice the rehabilitation practices at home three times per week for 7 weeks. They were followed up via telephone contacts weekly. Data gathering tools were a demographic questionnaire and the dyspnea and cough severity scale which were completed at baseline and 7 weeks after the intervention by the patients. Data were analyzed using the Chi-squared test, Fisher exact test, Independent and paired T tests, Mann whitney and Wilcoxon tests. There were significant differences between severity of dyspnea and cough before and after the intervention in the experiment group (P≤0.001); and between the two groups after the intervention (P≤0.001). The pulmonary rehabilitation program was effective in decreasing severity of symptoms in patients with chronic obstructive pulmonary disease.

Poor sleep quality is a common problem among patients with coronary artery bypass surgery. The aim of this study was to assess the effect of cardiac rehabilitation program on improving quality of sleep in patients with poor sleep quality after coronary bypass surgery. This was a quasi-experimental study. From 88 patients referred to the cardiac rehabilitation clinic of Tehran Heart Center, 50 patients with poor sleep quality were recruited to the study. patients after complete demographic and sleep quality questionnaires, participated in an 8-weeks cardiac rehabilitation program including exercise training and life style education sessions. Participants were followed-up 4 weeks after the intervention. Data were analyzed in the SPSS-18 using statistical tests such as Paired t-test, Independent samples T test, and One-way ANOVA. After cardiac rehabilitation program, significant differences were shown in the sleep quality (p<0.001) and its dimensions including subjective sleep quality (p=0.024), sleep disturbances (p=0.002), using sleep medications (p<0.001), and day time dysfunction (p<0.001). The findings showed that cardiac rehabilitation programs had positive effect on improving quality of sleep in patients after coronary artery bypass surgery.

Diabetes, as a chronic disease, needs self-management efforts. It is shown that having a regular exercise can lead to an increase in quality of life among patients with chronic diseases. The aim of this study was to compare the effect of yoga exercise with walking on quality of life among patients with type 2 diabetes. This quasi-experimental study was conducted on 60 patients with type 2 diabetes aged 30-55 years. The participants were randomly assigned into three: yoga, walking and control groups. Patients in the yoga and walking groups, had 45-minutes daily exercise for four weeks. Data were gathered using the SF-36 quality of life questionnaire and were analyzed using the one-way ANOVA in the SPSS-16. There were significant differences between the yoga and control groups after the intervention in terms of physical function, physical role, general health, vitality living, social function, mental role and mental health of the quality of life dimensions (P<0/05). There were significant differences between walking and control groups after the intervention in terms of physical function, physical role, general health, vitality living, mental role and mental health of the quality of life dimensions (P<0/05). Repeated measure ANOVA showed significant differences in terms of physical function, physical role, general health, vitality living, mental role and mental health of the quality of life dimensions in the three groups (P<0/05). According to the results of or study, yoga exercise was more effective in improving general health dimension of the quality of life.

Epilepsy is a chronic condition results in seizure and leads to debilitating conditions in patients. Epilepsy self-management behaviors include activities to manage the disease. The aim of this study was to assess self-management behaviors and its correlation with seizure frequency in patients with epilepsy. In this correlation study, 120 patients with epilepsy were selected from Iran Epilepsy Association using convenience sampling method. Data were collected using a demographic checklist, Dilorio´s epilepsy self-management behaviors scale and a checklist to record the number of seizures. Data were analyzed in the SPSS-16 using the correlation coefficient. The mean score of the self-management behaviors was 118.05±21.54. The highest score was in the area of seizure management (79.9) and the lowest score was in the area of drug management (57.56). There was a significant relationship between the epilepsy self-management behaviors and the frequency of seizures in patients with epilepsy (r=-0.3; P<0.001). The frequency of self-management behaviors was moderate. In patients with higher self-management behaviors score, seizures frequency was found to be lower.

Traumatic brain injury and resulted coma are major causes of death and disability. Coma stimulation techniques are recently proposed to improve coma status. The aim of this study was to assess the effect of hearing Azan on level of consciousness among patients. In this clinical trial, 33 patients with coma were randomly divided into two intervention and control groups. Patients in the intervention group received Azan sound using headphones 2 times a day, at noon and evening prayer times, for 14 days. Level of consciousness was measured at baseline and after each intervention. Consciousness level was recorded in the same way in the control group without any intervention. Data were analyzed in the SPSS-16. The patients aged 14 to 68 years old. At baseline, the mean consciousness scores in the intervention and control groups were 6.5 and 6.7, respectively. The mean consciousness scores were 11.6 in the intervention and 8.7 in the control groups in 14th day of the intervention. Repeated measure ANOVA showed that Azan sound increased consciousness level in the intervention group (P<0.001). Auditory stimulation using Azan sound increased level of consciousness in comatose patients.

According to the World Health Organization (WHO), responsiveness is the ability of health systems to meet the legitimate expectations of populations for non-clinical enhancing aspects of health system. Assessment of responsiveness can help to manage resource allocation and improve strategies. The aim of this study was to assess the responsiveness in outpatient clinics of Zanjan. This cross-sectional study was carried out in Zanjan hospitals’ outpatient clinics during 2013-2014. A total of 240 patients were selected systematically. The WHO’s responsiveness questionnaire was used to collect data. Data were analyzed using the descriptive and analytical statistics such as mean, frequency, percent, and the Student t -test and one way ANOVA in the SPSS 11.5. The majority of the respondents (over 73%) rated all aspects of the responsiveness as important. Half of the participants (50.6%) rated overall responsiveness as good. The best performance of responsiveness was related to confidentiality (76.3%) and dignity (63.8%) domains. The dignity was rated as the most important domain from outpatient's point of view. There was a statistically significant difference between the male and female patients regarding mean score of dignity. The finding of this study showed that there were gaps between the responsiveness performances and importance of all domains of the responsiveness. Achieving desirable status of responsiveness is essential.