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Background & Aim: Postoperative nausea is a common problem after general anesthesia, especially in ambulatory surgery. In ocular surgeries including strabismus surgery, intraocular pressure increase may lead to eye damage. Drug therapy has various side effects. The purpose of this study was to evaluate acupressure on nausea in patients undergoing strabismus surgery.

Methods & Materials: In this double-blinded clinical trial, 60 patients undergoing strabismus surgery were allocated into intervention and control groups. In the intervention group, a sea-band was placed on the P6 point of patients&apos wrists 30 minutes before induction of anesthesia. In the control group, the sea-band was placed in the opposite position of the patients&apos wrists. Data were collected during six hours after surgery in the recovery room. Data were analyzed using Chi square, t-test, and Mann-Whitney tests.

Results: There were no differences in demographic and surgical characteristics between the two groups at baseline. The intensity of nausea in the recovery room (P=0.002) and six hours after surgery (P<0.001) were significantly less in the intervention group than the control group.

Conclusion: Based on the findings of this study, acupressure decreases post operative nausea. Acupressure is a simple, noninvasive and cost- effective intervention which can be applied by nurses to prevent post operative nausea.

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  Background & Aim: Medication errors are known as the most common preventable and life threatening medical errors. This study aimed to explore perceptions of nurses on medication errors .

  Methods & Materials: This was a qualitative study with content analysis approach. Seventeen nurses were selected purposefully from the intensive care units of Shohada hospital in khoramabad in 2012. Data were gathered using semi structural interviews with the nurses. Data were analyzed using the Lundman and Graneheim method. We used the Linclon and Gouba method to ensure a ccuracy and trustworthiness of the data . 

  Results: Four main categories and six subcategories were recognized including: 1) Management factors (inefficiency in recruitment of human power, poor physical condition and workload) 2) Inefficiency in professionalism (lack of commitment among nurses, insufficient knowledge and inefficiency in the inter professional relationship) 3) Failure in the process of drug prescription by physicians and 4) Failure in production and packaging drugs by drug companies .

  Conclusion: Training and recruiting professional and committed nurses, using electronic medical files, supervision on pharmacy companies to produce and package proper medication can reduce medication errors .

  

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Background & Aim: The challenges that patients face after intestinal ostomy surgery can lead to impaired adjustment and self-efficacy. There is evidence suggesting these variables have reciprocal effects on each other. Therefore, the present study aimed to determine the correlation between adjustment and self-efficacy in patients with intestinal ostomy.

Methods & Materials: This descriptive correlational study was conducted on 76 patients with intestinal ostomy hospitalized in hospitals affiliated to Mashhad University of Medical Sciences using convenience sampling method in 2015. Research instruments were comprised of the demographic and disease information questionnaire, the Stoma Self-efficacy Scale, and the Ostomy Adjustment Inventory. The SPSS software v.19 using descriptive and inferential statistics was used to analyze the data.

Results: The results of Pearson correlation test showed a significant and positive linear correlation between the mean score of self-efficacy and the dimensions of adjustment: acceptance (P<0.001, r=0.518), anxious preoccupation (P<0.001, r=0.438), social engagement (p<0.001, r=0.488), and anger (P<0.001, r=0.384). Moreover, multiple regression analysis indicated that the dimensions of social engagement and acceptance have a significant and positive linear correlation with self-efficacy in patients with intestinal ostomy.

Conclusion: The results revealed that the dimensions of social engagement and acceptance of ostomy were the most important factors in relation to self-efficacy. Therefore, in order to care for patients with intestinal ostomy especially in the early months after surgery, it was recommended to help patients adjust themselves to the physical appearance of ostomy and maintain their social engagement, by designing and implementing appropriate educational and supportive interventions.

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The World Health Organization (WHO) has introduced palliative care as a way to improve the quality of life of patients with incurable diseases and their families. This care begins with the diagnosis of the disease, and continues throughout the illness (1). Palliative care improves the quality of life of patients with life-threatening diseases and their families. Its purpose is to relieve suffering through the identification, evaluation, and relief of pain and other physical, psychosocial and spiritual problems (2).
Palliative care is required for many diseases. According to reports, every year about 40 million people in the world need palliative care, but only 14% of them receive it, of whom 78% live in low-income or middle-income countries. According to the World Health Organization, patients who require palliative care services, suffer from cardiovascular diseases (38.5%), cancer (34%), chronic pulmonary diseases (10.3%), AIDS (5.7%), and diabetes (4.6%). Other patients with diseases, such as dementia, kidney failure, multiple sclerosis, Parkinson’s disease, rheumatoid arthritis, neurological diseases, congenital anomalies, and resistant tuberculosis may also need palliative care services (1). Palliative care can be offered to patients through various models, including hospital-based palliative care, hospice-based palliative care and home-based palliative care (3). Studies have shown that home-based palliative care has a very beneficial effect on the physical, mental, psychological, social and economic dimensions of patient’s life, and reduces the cost of health system, shortens the length of hospitalization, reduces hospital complications and prevents hospital readmission (4-6). This type of care also facilitates the continuity of post-discharge care and helps patient to easily benefit from the facilities of different centers (7). On the other hand, most people prefer to receive care at their homes with their families (8). Studies have shown that home-based palliative care is clinically and economically effective and leads to the satisfaction of patients and their families. Also, the World Health Organization in 2014 has introduced home-based palliative care as one of the main elements of the health systems all around the world (1). However, reports indicate that many countries in the world do not have palliative care programs in their health care system (7), and the lack of government support for palliative care services, lack of prepared professional staff to provide palliative services, limitation in access to narcotic analgesics, resource constraints, lack of policy-makers’ familiarity with palliative medicine, the negative attitude of society towards palliative care and socio-cultural issues have been mentioned as barriers to palliative care in the world (1, 9,10).
Iran’s health system is faced with increasing number of chronic patients and shortages of manpower and ICU beds in health centers. Most patients with life-threatening diseases in Iran are frequently admitted to hospital during the last days of their lives. Despite the shortage of hospital beds, especially in the critical care units, these patients occupy these beds and receive specialized medications until the end of their lives and eventually many of these patients die on ICU beds in hospital (11). While in many cases, hospitalization of incurable patients in critical care units does not have any positive effects on patients’ recovery, and is considered a futile care (12), which increases the costs of health system, poses financial burden on patient’s family, and leads to dissatisfaction and work burnout in healthcare staff (13). On the other hand, many of these patients prefer to spend the last days of their lives at home with their family and be in close contact with their relatives. Evidence suggests that palliative care in Iran is only offered in isolated and limited centers. Most patients are deprived of this kind of care, and home-based palliative care does not have any place in Iran’s health system (14). Patients with incurable conditions who require palliative care services are lost in the system, and in most cases do not receive proper and timely services they need (15). Also, the traditional attitude of healthcare staff towards the management of incurable conditions, the lack of transparency in the protection of healthcare staff against discontinuation of unnecessary treatments or unreasonable expectations of patients and their families, as well as social and cultural differences are barriers to the promotion of palliative care in Iranian society. Another problem in providing home-based palliative care services is the defect in the payment process and insurance coverage of end-of-life patients (16,17). Therefore, given the high prevalence of chronic and incurable illnesses, the increasing number of elderly population, limited critical care beds, shortages of human resources, limited financial resources and equipment in health centers, and taking into account the benefits of home-based palliative care, healthcare system authorities should consider this care method to be one of the important priorities of the health system so that patients can maintain their quality of life and also experience peace during the last days of their lives. Considering the limited research in this field, further research is required on the management of various dimensions of home-based palliative care in order to provide suitable models for the provision of home-based palliative care services in Iran.
 

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Background & Aim: Many patients with cardiovascular disease suffer from some degree of anxiety after admission to the Cardiac Care Unit (CCU). Anxiety adversely affects patients’ recovery. High levels of anxiety increases mortality risk up to three times. This study aimed to determine the effect of pre-operative supportive care plan on anxiety of patients with acute coronary syndrome after admission to CCU.
Methods & Materials: In this clinical trial, 74 patients with acute coronary syndrome, admitted to the Cardiac Care Unit of Vasei hospital of Sabzevar in 2016. Participants were selected via convenience sampling and randomly divided into two groups of intervention and control. The control group only received routine nursing care. For the intervention group, besides routine care, the supportive nursing care was delivered on the intellectual, emotional and physical domains. The Beck Anxiety Inventory questionnaire was completed by both groups before and after the intervention. The data were analyzed by the Mann-Whitney U test and independent t-test using the SPSS software version 16.
Results: Before the intervention, no significant difference was observed in the anxiety score between the intervention and control groups (P=0.162). After the intervention, the anxiety score in the intervention group was lower than in the control group (P=0.023).
Conclusion: According to the results of this study, supportive care plan reduced anxiety in the intervention group compared to the control group. Therefore, supportive care plan is recommended for reducing anxiety in these patients.
Clinical trial registry: IRCT2015123025767N1
 

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Background & Aim: Dialysis headache is one of the most common complications of hemodialysis and is often a challenge for nephrologists, neurologists and headache specialists. Therefore, this study was conducted to investigate the effect of inhalation aromatherapy using lavender on the severity of headache in hemodialysis patients.
Methods & Materials: In this randomized clinical trial, 82 patients from hemodialysis wards of Golestan Hospital in Ahvaz and Shahidzadeh Hospital in Behbahan in 2019 were selected and randomly assigned to either intervention or control groups using the stratified permuted block randomization. For the intervention group, cotton soaked in three drops of lavender essential oil 20% was attached to the collar of the patient and he/she was asked to inhale it for 30 minutes. For the control group, distilled water was used. The intervention was repeated for four weeks (three days per week). The severity of dialysis headache was measured using the Numeric Rating Scale.
Results: In the intervention group, both the severity and the frequency of dialysis headache decreased during 12 sessions of aromatherapy, compared to the control group (placebo), and the decrease was statistically significant (P˂0.001).
Conclusion: Due to the fact that complementary medicine has increasingly become a part of nursing care, aromatherapy with lavender can be used as a complementary measure reducing the severity and frequency of dialysis headaches.
Clinical trial registry: IRCT20190718044263N1