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Background & Aim: Intradialytic hypotension is the most frequent complication in patients receiving haemodialysis (HD). This complication not only contributes to the illness of the patients, but also decreases the efficacy of the HD. So, hypotension prevention is a major challenge for medical team, especially for nurses. One of the preventive methods that have recently been presented is the use of sodium profile and ultra filtration (UF) profile. The aim of this study was to compare the effects of linear sodium + UF profile (type1) with stepwise sodium + UF profile (type3) on systolic and diastolic blood pressure in HD patients.

Methods & Materials: In this crossover design study, 26 HD patients from two dialysis centers at Esfahan University underwent three kinds of treatment: (1) control, constant dialysate sodium concentration of 138 mmol/L with constant UF (2) linear sodium profile + UF profile (type1), a linearly decreasing dialysate sodium concentration (146-138mmol/L) in combination with a linearly decreasing UF rate and (3) stepwise sodium profile + UF profile (type2), a stepwise decreasing dialysate sodium concentration (146-138 mmol/L) in combination with a stepwise decreasing UF rate. Each treatment was applied in three dialysis sessions. Data were analyzed using repeated measure ANOVA test in the SPSS.

Results: Twenty six patients participated in the study. A total of 234 dialysis sessions were analyzed. There were no significant differences in the systolic blood pressure between three groups during predialysis and first and the second hours (P>0.05). The mean of systolic blood pressures were higher in the third hour and postdialysis during two types of profiles (1&3) compared with the routine care group (P<0.05). The mean of diastolic blood pressure was also higher in postdialysis during two types of profiles (1&3) compared with the routine group (P<0.05). There was no significant difference between the profiles 1and 3 (P>0.05).

Conclusion: In conclusion, sodium profile + UF profile is a simple and cost-effective method that modulate the dialysate sodium and ultra filtration rate and preserve the homodynamic status and blood pressure of patients during dialysis. Therefore, using sodium profile + UF profile (type1 & type3) is recommended in order to prevent hypotension and reduce nursing work during hemodialysis process.

 

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Background & Aim: Pregnancy is one of the enjoyable and evolutionary aspects of women’s life, which is often associated with many stresses and concerns. Counseling is one of the most appropriate interventions to reduce concerns and increase the decision-making power of pregnant women. This study aimed to determine the effect of solution-focused group counseling on pregnant women’s worries.
Methods & Materials: A randomized clinical trial was conducted on 108 pregnant women with gestational age of 6 to 19 weeks and a score of worry ≥55, from May to September 2017 in health centers of Sabzevar University of Medical. The intervention group received a solution-focused counseling and the control group received routine prenatal care. Concerns of pregnant women were evaluated before, after, and two months after the intervention using the Farsi version of Cambridge Worry Scale. The data were analyzed using t-test, chi-square, and repeated measure analysis of variance through the SPSS software version 22. A P value less than 0.05 was considered statistically significant.
Results: The mean score of worry before the study was 58.9±5.9 for the intervention group and 58.8±4.37 for the control group, and no significant difference was observed. After the intervention, these values for the intervention group and the control group were 34.6±13.3 and 57.7±8.78, respectively. Two months after the study, these values were 31.1±10.1 and 54.6±10.9, respectively. The analysis of variance with repeated measurements showed that pregnant women’s concerns about childbirth, fetal health, maternal health, and family relationships were significantly reduced after the intervention and two months later (P<0.001). Women’s worries about socioeconomic issues were not significantly reduced after the intervention and two months later in comparison with the control group (P=0.563).
Conclusion: The solution-focused counseling is an effective way to reduce pregnant women’s concerns about maternal and fetal health, family relationships and childbirth. It can be used in conjunction with pregnancy care.
Clinical trial registry: IRCT20180123038485N1