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Background & Aim: Hypothermia is a main side effect during surgery in which blood pressure, heart rate, intra cranial pressure, oxygen consumption, pain and discomfort increase. The rate of cesarean section in Iran is three times more than global standard. This study aimed to investigate effect of pre-warmed intravenous fluid therapy on prevention of shivering after general anesthesia in cesarean section.

Methods & Materials: A total of 62 women undergoing general anesthesia for elective cesarean section were randomly allocated into two intervention and control groups. In the intervention group, patients received pre-warmed serum (37°C) and in the control group, patients received serum at room temperature (25.5°C). The postoperative shivering and some homodynamic parameters of the participants were assessed in recovery room.

Results: The mean of body temperature in the intervention and control groups were 35.9°C±0.48 and 35.42°C±0.6, respectively (P<0.05). The incidence of post operative shivering in the intervention and control groups were 13% and 35%, respectively (P<0.05).

Conclusion: Infusion of pre-warmed serum (37°C) would prevent postoperative shivering and could improve nursing care for women underwent general anesthesia in cesarean section.

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  Background & Aim: Several studies have shown that the self-care activity of patients with implantable cardioverter defibrillator is inadequate. This study was conducted to assess the effect of an educational program based on the Orem’s self-care model in self-care ability of the patients .

  Methods & Materials: This clinical trial was conducted among 66 patients with implantable cardioverter defibrillator. Four educational sessions were held based on the patient's needs and Orem’s self-care model. Data was collected using a self-report questionnaire at baseline and one month after the intervention. Data were analyzed using statistical tests (x², t-test, paired t-test) in the SPSS-18 . 

  Results: There were no significant differences in the self-care awareness, tendency to self-care, self-care skills, and self-care ability between the control and intervention groups. After the intervention, the self-care awareness score remained 22.06 ± 3.26 in the control group and increased (28.69 ± 1.51) in the intervention group (P<0.000). There was also significant difference in the tendency to self-care between the control (25 ± 3.31) and intervention (28.9 ± 1.33) groups (P<0.000). The self-care skills differed significantly between the control (14.9±3.06) and intervention (29.03±1.15) groups after the intervention (P<0.000). After the intervention, the self-care ability was also significantly different among the control (61.96±8.06) and intervention (86.63±2.93) groups (P<0.000) .

  Conclusion: The results of this study showed that implementing educational programs based on the Orem’s self-care model can improve self-care ability in patients with implantable cardioverter defibrillator. Applying this method is recommended in nursing interventions to promote health status of the patients .

  

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  Background & Aim: Women who experience anxiety during labor are more vulnerable to physical and mental illnesses. Emotional support by a knowledgeable individual can improve physical and even mental conditions. This study aimed to determine the effect of presence of a Doula in delivery unit on parturient women’s anxiety .

  Methods & Materials: This is an experimental study using a randomized interrupted time series with a control group. Using convenience sampling, 64 parturient women with research inclusion criteria were randomly assigned to the control or intervention groups. The parturient women in the intervention group benefited from presence of a Doula and her support. The control group received the usual care without presence of the Doula. Data were collected using the Spielberger state-trait anxiety inventory and a checklist. The results were analyzed using parametric and non-parametric statistical tests in the Stata-11 . 

  Results: The age, education, family income, location of residency, the trait and state anxiety did not have any differences between the two groups at the baseline. After the intervention, the state anxiety was reduced significantly in the intervention group compared with the control group at the time of leaving the labor room, delivery room and recovery room (P<0.001) .

  Conclusion: According to the present research findings, Doula can significantly reduce the anxiety level and its complications among parturient women during childbearing .

  

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  Background & Aim: Patients with multiple sclerosis suffer from permanent pain. It is being increased to apply relaxation therapy to decrease patients' pain. The progressive muscle relaxation make the muscles feel more relaxed. The aim of this study was to assess the effect of progressive muscle relaxation on pain among patients with multiple sclerosis .

  Methods & Materials: A randomized controlled trial was carried out among 70 patients with multiple sclerosis selected from Hamadan Multiple Sclerosis Society patients. Inclusion criteria involved diagnosed with multiple sclerosis, 20-65 year old patients, having ability to do daily 20-minute exercises, feeling pain, having an EDSS score equal or less than 4.5. Patients were randomly divided into two groups of control and intervention. Patients' pain was measured using the VAS scale in the two groups at baseline. The relaxation training was implemented among intervention group patients and was repeated three times a week for four weeks. Each session lasted 40 minutes and the patients continued doing exercise at home for the other eight weeks. The control group patients were observed routinely. Patients' pain was measured eight weeks later in both groups. Data were analyzed using the paired independent t-test in the SPSS-16 .

  Results: Muscle relaxation had significant effect on pain among patients with multiple sclerosis (P<0.05). The mean of pain severity decreased from 4.60 ± 1.75 to 3.26±1.88 in the intervention group after the intervention. The mean of pain severity remained constant .

  Conclusion: This progressive muscle relaxation can be used for decreasing pain among patients with multiple sclerosis as a non-expensive, safe and simple method .

  

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  Background & Aim: Insertion of chest tubes is a necessary measurement in chest trauma. The trauma patients need specific skills for self-care. This study aimed to determine the effect of using supportive-educative system on self-care skills in trauma patients with chest drainage system .

  Methods & Materials: In this quasi-experimental study, 62 trauma patients with chest-tube were selected from three surgery wards of Besat hospital in Hamadan from December 2012 to May 2013. Two wards were randomly allocated into the experiment group (n=31) and one ward was allocated into the control group (n=31). Participants were selected using convenience sampling. The supportive-educative system was designed based on the patients’ needs and was implemented to the experimental group in three consecutive days. The study instruments included self-care needs assessment form and self-care skills checklist. Measurements were completed once the patients were admitted to the wards and three days later by an external observer. Data were analyzed using t-test, Chi-squared test, Mann-Whitney and Wilcoxon tests with a 95% confidence level in the SPSS-16 . 

  Results: There were no significant differences between the two groups in the study variables at baseline (P>0.05). Although self-care skills in both control (P<0.01) and experiment (P<0.001) groups were improved, using educative-supportive system led to better self-care skills in the intervention group in compare to the control group (P<0.001) .

  Conclusion: In general, self-care skills of patients with chest drainage system could be improved by supportive-educative system. The improvement in the control group can be attributed to self-care trainings conducted routinely by doctors and nurses .

  

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Background & Aim: Spiritual care along with other nursing interventions balance body and soul. This study aimed to determine the effect of spiritual care on death anxiety in hemodialysis patients with end-stage of renal disease.
Methods & Materials: A clinical trial (IRCT2016308226961N1) was performed in Hamadan’s Shahid Beheshti and Besat hospitals in 2016. A total of 60 hemodialysis patients with end-stage of renal disease were randomly assigned into two groups of intervention (30 patients) and control (30 patients). In the intervention group, the spiritual care program consisted of protective care, supporting the patient’s rituals and using the support systems, was performed in hemodialysis ward at the patient’s bedside. The control group only received routine nursing care. The Templar’s death anxiety questionnaire was completed by both groups before and after the intervention. Data were analyzed by descriptive and inferential statistics using the SPSS software version 16.
Results: The average score for death anxiety before the intervention between the intervention group (8.10±2.26) and control group (8.53±2.47) had not significant difference (P=0.482), while the average score for death anxiety after the intervention had statistically significant difference (P=0.004) between the intervention group with median value of 8.0 (6.00-8.25) and control group with median value of 9.0 (7.00-10.25), and the patients’ death anxiety reduced in the intervention group.
Conclusion: Spiritual care program reduced death anxiety in hemodialysis patients with end-stage of renal disease. Nurses can use spiritual care program to reduce patients’ death anxiety.
 

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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