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Background & Aim: Premature infants undergo painful and stressful procedures during care and treatment. Nurses can help to reduce short- and long-term effects of pain caused by diagnostic and therapeutic procedures using various methods including music therapy. The aim of this study was to assess the effect of music therapy on physiological pain responses of premature infants during and after blood sampling.

Methods & Materials: This was an experimental study with crossover design conducted on 20 premature infants hospitalized in the intensive care unit of a hospital affiliated to the Tehran University of Medical Sciences for a five months period in 2010-11. Infants were randomly allocated in two groups of experiment and/or control. Each infant was considered as its own control. We assessed the physiological pain responses caused by blood sampling such as heart rate and oxygen saturation level. Infants in the experiment group listened to the Transitions music five minutes before until 10 minutes after the blood sampling. The responses were recorded and reviewed ten minutes before until ten minutes after the blood sampling in both groups and physiological changes were detected. Data were analyzed using ANOVA and Chi-square tests in the SAS and SPSS.

Results: Results showed significant difference in heart rate between the experiment and control groups during needle exit (P=0.022). There was also significant difference in heart rate between experiment and control group in the first 5 minutes of blood sampling (P=0.005).

Conclusion: Results showed that music therapy could reduce some physiological responses of pain during and after blood sampling. Music therapy can be used as a beneficial intervention following painful procedures such as blood sampling in the NICU.

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  Nurses’ turnover phenomenon is a major concern in healthcare systems of many countries. In recent years, nursing shortages in Iran has become a major challenge for healthcare system managers. Based on the definition, “turnover” is a process in which employees leave an organization or transfer to other departments or units of the organization. However, in this definition it has not been specified whether members’ turnover is voluntarily or involuntarily (1). Also, nurses are vital components of healthcare systems, so that as the largest group, they constitute about 56% of the hospital staff (2). Lack of knowledge about nurses’ turnover makes it hard for managers of healthcare systems to recognize its effect and it complicates the efforts to fill nurses’ vacancies (3). This complex issue has been affected by several factors. Turnover and relocation of nursing employees have affected medical expenses through impact on patients’ resultants.

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Background & Aim: The experience of domestic violence has negative consequences on the mental health of pregnant women, and interventions must be designed to reduce these negative consequences. Therefore, the aim of this study was to determine the effect of supportive-educational intervention on psychological distress among pregnant women subjected to domestic violence.
Methods & Materials: This clinical trial was conducted on 100 pregnant women subjected to domestic violence, referred to comprehensive health centers of Zahedan for receiving prenatal care in 2018. Eligible women were selected by the convenience sampling method and randomly assigned into two groups of intervention and control. The intervention group received four supportive-educational individual sessions during two weeks. The control group received routine care during this period. Data were collected in two groups by the Kessler Psychological Distress Scale (K10) and Hurts, Insults, Threaten, Screams (HITS), before the intervention and four weeks after the intervention. The data were analyzed by statistical tests using the SPSS software version 21.
Results: The results showed that the mean score of psychological distress of pregnant women dropped from 30.9±4.58 to 22.18±3.81 (mean change score -8.72±3.93) in the intervention group and from 25.22±4.15 to 24.06±4.16 (mean change score -1.16±1.48) in the control group. Analysis of covariance demonstrated that there was a statistically significant difference in the mean score of psychological distress of pregnant women exposed to violence between the two groups after the supportive-educational intervention (P<0.001).
Conclusion: The results of this study showed that the supportive-educational intervention is effective in reducing psychological distress in pregnant women subjected to violence. Therefore, it is recommended to integrate supportive-educational interventions into prenatal care for pregnant women subjected to violence in order to improve fetal and maternal health.
 

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Background & Aim: The healthy nutrition education is one of the most important priorities in all life periods, especially in childhood. The teaching method is also considered one of the important factors for the effectiveness of education. Therefore, the aim of this study was to compare the effect of lecture and role-playing methods on awareness of healthy nutrition in school-age children.
Methods & Materials: This quasi-experimental study was conducted on 60 primary school students in Gonabad city in 2017. Participants were selected by multistage random sampling and allocated into two groups of role-playing and lecture. Students' awareness was measured by a self-structured questionnaire before, immediately and one month after education. Data were analyzed using the SPSS software version 16 by descriptive and inferential statistics. A P-value less than 0.05 was considered significant.
Results: The mean score of awareness for the role-playing group before, immediately and one month after the intervention respectively was 10.77±2.55, 14.1±55.15 and 14.50±1.10 and for the lecture group respectively was 11.07±1.85, 13.72±1.43 and 11.47±2.84 (the score range: 0-16). There was a significant difference in the mean score of awareness before, immediately and one month after the intervention between the two groups (P<0.001), and in the role-playing group, the increase in awareness score was more than in the lecture group.
Conclusion: Considering the greater effect of role-playing method than lecture on healthy nutrition education in school-age children, it is suggested that more attractive, dynamic and effective methods such as role-playing, in accordance with educational behavioral goals, be used in school nutrition education programs. In addition to enhancing educational efficiency, this will make the effects of education and learning more sustainable for students.
 

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Background & Aim: Although pain control in patients with burns has improved over recent years, the ineffectiveness of some treatments to reduce pain in this group of patients remains a challenging issue for health care professionals. This systematic review was conducted to investigate nursing interventions in the field of pain relief in burn patients.
Methods & Materials: In this systematic review and meta-analysis, relevant information was searched from databases PubMed, Science Direct, Scopus, Irandoc, SID, and Cochrane library with keywords nursing interventions, pain, burns and their equivalent Persian keywords in the period 2010-2020. To increase the validity and reliability of the study, three people evaluated the quality of the articles separately and Jedad criterion was used to evaluate the articles.
Results: After assessing 181 articles on the databases, 19 articles were systeatically reviewed. Nursing interventions to reduce pain in burn patients included using breathing techniques, new dressings, muscle relaxation, music therapy, transcutaneous electrical nerve stimulation (TENS), electrical brain stimulation, play therapy, aromatherapy, use of Zekr Allah, massage, guided imagery, distraction techniques, and eye movement desensitization. In eight meta-analyses, total mean differences of pain relief score were estimated 1.28 (0.95% CI: 0.78-1.78).
Conclusion: Most nursing interventions reduced pain in burn patients. Easier-to-use pain relief techniques such as muscle relaxation, guided imagery, and spiritual care are emphasized.

 

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Background & Aim: Considering the use of aromatherapy as a non-pharmacological method of pain control and a scarcity of studies in this area, the aim of the study was to compare the effect of breast milk odor and Rosa damascena aroma on pain and crying due to blood sampling in neonates.
Methods & Materials: In this cross over clinical trial study, 40 neonates hospitalized in the NICU of Ali Ibn Abitalib hospital in Rafsanjan were divided into two groups (breast milk odor and Rosa damascena aroma). In the first step, tree minutes before blood sampling until its completion, cotton soaked in 2 cc of breast milk was placed at a distance of three centimeters from the neonate’s nose. In the next step, cotton soaked with two drops of rose essential oil was used, similar to the method of breast milk. For the second sample, the order of interventions was changed. The pain was calculated with the NIPS instrument and crying with a stopwatch by a person who was blinded to the groups. The data were analyzed by STATA software version 14.
Results: The mean score of pain for two periods in two groups were 3.75±2.33 and 4.30±1.70 respectively, and there was no significant difference between the two groups (P=0.415). The mean score of crying for two periods in two groups were 16.98±16.21 and 15.03±9.99 respectively, and there was no significant difference between the two groups (P=0.650).
Conclusion: The breast milk odor and rose damascena aroma have a similar effect in reducing the pain of neonates. Thus, according to the conditions, each of these methods can be used.
Clinical trial registry: IRCT20150713023190N11

 

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Background & Aim: Hypotension is a common complication associated with plasmapheresis. Elevating the legs and using elastic stockings are nursing interventions aimed at preventing hypotension. The objective of this study was to compare the effects of elastic stockings and leg elevation on the prevention of hypotension during plasmapheresis.
Methods & Materials: This randomized crossover clinical trial was conducted on 35 patients undergoing plasmapheresis at Beheshti Hospital in Hamadan from 2020 to 2021. Patients were selected based on convenience sampling and then allocated to four different methods in four sessions using random permuted block designs: elastic stockings (A), leg elevation (B), a combination of elastic stockings and leg elevation (C), and a control group (D). Blood pressure was monitored before, during (every half hour), and half an hour after the completion of plasmapheresis. Data analysis was performed using SPSS version 24, applying repeated measures ANOVA with a significance level of 0.05.
Results: During plasmapheresis, systolic blood pressure decreased over time in all four methods (P<0.001). Blood pressure measurements in intervention methods A, B, and C were higher than in the control group (P<0.001). Among the intervention methods, blood pressure in method C was higher than in methods A and B, while method B was higher than method A (P<0.001).
Conclusion: The use of elastic stockings in combination with leg elevation is more effective in preventing hypotension. Therefore, it is recommended as an easy and cost-effective method for preventing hypotension in patients undergoing plasmapheresis and for nursing staff to implement.
Clinical trial registry: IRCT20191020045166N1

 

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Background & Aim: End-stage renal failure requires careful and effective planning in the hemodialysis process to improve patients' quality of life and reduce complications. Therefore, this study aimed to investigate the impact of using cold dialysis solution on sleep quality and blood pressure changes during hemodialysis in patients with end-stage renal failure.
Methods & Materials: This blinded randomized clinical trial included 82 patients undergoing hemodialysis in Baqiyatallah and Milad hospitals in Tehran in 2023. Patients were randomly assigned to either the intervention group (41 individuals) or the control group (41 individuals). The intervention group received hemodialysis with cold dialysis solution (35°C), while the control group received standard dialysis solution (37°C) for 4 weeks. Data was collected using a demographic and disease characteristics form, Richard Campbell Sleep Quality Questionnaire (RCSQ), and a mercury sphygmomanometer. Data analysis was conducted using SPSS version 26 software, utilizing Mann-Whitney, independent t-test, chi-square, and paired t-test.
Results: The mean sleep quality score in the cold hemodialysis group (35°) after dialysis was significantly higher than the standard group (37°) (P=0.004). No significant difference was observed between the two groups before dialysis (P=0.759). There was no significant difference between the mean systolic and diastolic blood pressure scores before dialysis in the two groups. However, after dialysis, the reduction in blood pressure (systolic and diastolic) in the cold hemodialysis group was significantly less than in the standard group (P<0.001).
Conclusion: The results of this clinical trial showed that the use of cold dialysis solution during hemodialysis significantly improved the sleep quality of patients with end-stage renal failure and reduced blood pressure changes during treatment. These findings can be used to improve the treatment process and enhance the quality of life of these patients.
Clinical trial registry: IRCT20230521058244N1