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This study was conducted to determine the effect of energy therapy Method on anxiety and incidence ofcardiacdysrhythmiainpatientsundercatheterization.Thenvestigated units consisted of 68 patients that were randomly assigned into 3 groups: 26 patients in case group, 21 patients in placebo group and 21 patients in control group . The case group underwent the course of study through energy therapy method for 10-15 minutes ,one hour before catheterization. Furthemore, placebo group received mimic energy therapy within the same period of time, i. e (the method was the same as energy therapy except in this method no energy was transferred, and the procedure was unreal and mimicking). Moreover the control group received no treatment.For collection of data, the questionare and observation checklist were used. The anxiety of the patients was measured through speilberger anxiety -test, an hour before and during catheterization.The cardiac dysrhythmia and dysrhythmia during catheterization were recorded on an observation checklist.The results showed that energy therapy had a significant effect on the situational anxiety of the investigated units in case group and through energy therapy, their anxiety were reduced, (p=000)however, it had no considerable effect on the anxiety related to the characteristic of the individuals. In addition to the above, energy therapy could be effective in reducing the incidence of cardiac dysrhythmia such as: sinus tachycardia, (p=0.00005),V.T (p=0.005), PAC(p=0.001)and PVC.(p=0.01) The results also showed that energy therapy is a method reducing the anxiety of the patients in catheterization room, it could also be effective in reducing the complications such as cardiac dysrhythmia regarding to catheterization. Therefore, the investigation hypothesis was approved.

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Background & Aim: Improving the quality of life is generally one of the main goals in caring of the patients with congestive heart failure, so identifying factors affecting it is significantly important. This study was conducted to determining the quality of life of these patients.

Methods & Materials: 184 of patients congestive heart failure who referred to clinics of Tehran University of Medical Sciences were chosen by goal-based sampling method. Data collection was done by questionnaire, which was consisted of 4 parts: individual factors, factors related to disease, patient knowledge and quality of life. Data analysis was done by SPSS computerized software.

Results: Most of the researching samples in fallowing dimensions had undesirable quality of life: physical activity dimension (44.6%), Psychological dimension (47.3%), Economical/Social dimension (49.5%), total Quality of life (46.7%) and had fairly desirable quality of life in general health dimension (42.4%). There is a significant statistical relationship between quality of life and these variables: job, Education level, care giver, the intensity of illness, duration of illness period, number of refers to physician and hospitalization, duration of combination of hypertension with CHF, presence of edema, high cholesterol, characteristics of disease, the intensity of fatigue at the time of research and in last 1 month ago (p=0.000) and the kinds of using drugs (p=0.039), but there is not a significant statistical relationship between quality of life and these variable: age, gender, Marriage status, Number of people living together, Having therapeutic insurance, Smoking, Body Mass Index: BMI presence of Myocardial Infarction or other diseases and patient knowledge.

Conclusion: Congestive heart failure has a negative affect on quality of life. So assessing the quality of life and promoting it is viewed as one of the duties of nurses and also as one of the major caring goals.

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Background & Aim: Some aspects of life style in adulthood have major preventive role from osteoporosis in adult ages. This research has been done in order to determining female teenager’s life style in relation with prevention of osteoporosis.

Methods & Materials: This research was a descriptive - analytical study. In this study, 760 person of female teenage students in high schools and pre-university centers of zone 17 in Tehran city were chosen by random classified cluster sampling method. In this study, the tool for data collection was written questionnaire, and method of it was answering to questionnaire. The questionnaire had 2 parts. First part included demographic characteristics, and second part included different dimensions of lifestyle in relation with prevention of osteoporosis, such as nutrition, exercise and physical activity, habits (smoking, using weight loss food regimen and weight loss drug). The life style categorized as 3 levels unfavorable, partially favorable, and favorable. The collected information was assessed by SPSS software and descriptive and analytical statistical methods were used to reaching study objects.

Results: Results Showed nutrition, phisycal activity and exercise the highest percent of cases (51.8%, 57.7%) had undesirable lifestyle. Also 50 percent of cases had undesirable lifestyle. About habits (Smoking, using weight loss food regimen and using weight loss drug) the highest percent of cases (74.9%) had desirable lifestyle. Also there was a significant statistical relationship between life style and variables of education level (p=0.004), economical status of family (p=0.043), the birth number in family (p=0.001) and educational level of mother (p=0.005).

Conclusion: According to the results of research, lifestyle of 50% of female teenagers was undesirable. Findings of this research are attentive and need more assessment and planning by responsible people in order to omitting noted problems in lifestyle.

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Background & Aim: Nowadays, mechanical ventilators are being used for some patients in ICUs due to various physiological and clinical causes. Keeping endotracheal tube clean and open is necessary in order to improve the patient&aposs oxygenation. This study aimed to investigate the effects of open and closed system endotracheal suctioning on vital signs of patients in ICU.

Methods & Materials: In this quasi-experimental study, 40 patients from Shariaty Hospital&aposs ICU were selected using convenience sampling method. Data was collected using a record sheet. The sheet consisted of demographic characteristics and vital signs including blood pressure, mean arterial blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation percentage. Endotracheal suctioning was done randomly in 90 minute intervals once using closed method and once using open method. All patients were hyper oxygenated by Ambo bag for 2 minutes before and after the procedures. The patients&apos vital signs were checked and recorded using SIEMENS 680 2xi monitor before, and 2 minutes and 5 minutes after the procedures. Data were analyzed using SPSS software.

Results: Systolic and diastolic blood pressures, and heart rate showed higher increase 2 and 5 minutes after the open method compared to close method (P<0.001). Arterial blood oxygen saturation percentage reduced in the open method more than in the closed one 2 and 5 minutes after the procedure (P<0.001). No significant difference was seen in the patients&apos respiratory rate in two methods (P>0.05).

Conclusion: Closed endotracheal suction system results in lower disturbances in the vital signs than the open system. Therefore, for better results, the closed endotracheal suctioning is suggested.

 

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Background & Aim: Blended E-Learning is an educational method which has been used recently in higher education worldwide. So, it seems that it is crucial for the Iranian academic members to accept it as a new educational method. This study was conducted to investigate attitudes of the faculty of Nursing and Midwifery School at Tehran University of Medical Sciences toward blended E-learning.

Methods & Materials: In this cross-sectional study, all faculty members of Tehran University of Medical Science (n=60) were recruited to the study. Data were gathered using validated and reliable self-designed questionnaires. The collected data were analyzed using SPSS software.

Results: The response rate was 93.33% (n=56). Most of the respondents (85.7%) were female. The mean age was 44.88 (SD=5.6). The years of teaching ranged from 5-30 years (mean=16.75). The majority of the respondents (66%) had positive attitude toward blended e-learning thirty four per cent had completely positive attitude and none of them had negative attitudes. About 41% reported that they were eager to provide their course syllabuses according to this approach and 87.5% said that they were willing to attend the blended e-learning education workshops. There were no significant relationships between demographic variables and the attitudes. There was a significant relationship between willing to attend the workshops and positive attitude toward blended e-learning (P=0.012).

Conclusion: According to the positive attitude of the respondents toward blended e-learning, it is recommended that further studies take place in order to design and implement the approach in formal education in the school of Nursing and Midwifery of Tehran University of Medical Science.

 

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Background & Aim: Cigarette smoking is a common risky behavior among teenagers. Theories and models of health education aim to design effective educational programs. This study has been conducted to assess the effect of a health education program designed based on the health belief model on preventive smoking behaviors among female teenagers.

Methods & Materials: In this quasi-experimental study, 176 female teenagers from the Educational Cultural Centers of 17 zones of Tehran Municipality were randomly allocated to two equal experiment and control groups (88 girls in each group). The designed educational program was presented to the experiment group through three lecture and question/answer 45 minute sessions. Data were collected using a questionnaire before and eight weeks after the intervention. Data were analyzed using the SPSS-16.

Results: There was no significant difference between the two groups in the characteristics of the participants before the intervention. Comparison of the two experiment and control groups after education showed that the mean score of all studied constructs of the health belief model (i.e., susceptibility, severity, benefits and barriers, cues to action), as well as the preventive behaviors were increased significantly.

Conclusion: The results of this study showed that the program seems to be helpful in promoting the smoking preventive behavior among teenagers.

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Background & Aim: Delirium is a common problem among patients with open heart surgery admitted to intensive care units. This study aimed to assess effectiveness of a multifactor intervention on delirium prevention and length of stay in patients with open heart surgery.

Methods & Materials: In this semi-experimental study, we first recruited 195 patients. Among them, 15 patients were excluded during the study due to different reasons. The participants were divided into to study groups. The implemented intervention included staff education, environment changes, and installation of guideline reminding on ward. Patients were assessed for delirium twice a day using the CAM-ICU scale. Demographic characteristics as well as disease and sleep items were completed by the researchers a day before surgery. Moreover, length of stay was recorded by the researchers. Data were analyzed using Pearson Chi-Square, Independent Samples, and the Fisher&aposs Exact Test.

Results: A significant decrease was found in the incidence of delirium in the intervention group: 11.1% Vs 35.6% (P<0.05). Average length of stay in the control and intervention groups was 6.23 Vs 6.30 days, respectively. Length of stay among patients with delirium and patients without delirium was 7.5 Vs 5.8 days, respectively. Patients with delirium were aged 55 and more in both groups.

Conclusion: Multifactor intervention was effective in decreasing the prevalence of delirium. Educational interventions are recommended to improve staffs&apos knowledge and environment changes.

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Background & Aim: The presence of pain is a common phenomenon among patients in critical care units. Critically ill patients are often unable to communicate because of illness or sedation so, recognition and assessment of their pain is difficult. In these patients, observational behavioral indices can be used to evaluate pain. The aim of this study was to investigate the effect of application of critical-care pain observation tool in patients with decreased level of consciousness on performance of nurses in documentation and reassessment of pain after palliative intervention.

Methods & Materials: In this before and after quasi-experimental study, 106 nurses working in general intensive care units in selected hospitals affiliated to Tehran University of Medical Sciences were selected. First, we examined the nurses&apos performance three times in relation to documentation and reassessment of pain after palliative intervention, position change and suction procedure in patients with decreased level of consciousness using a researcher-made check list. Then, we taught nurses individually, how to use this tool to investigate the pain of patient in a session lasting an hour. A week after the training, the researcher reevaluated performance of trained nurses in relation to documentation and reassessment of pain after palliative intervention in patients with decreased level of consciousness. Finally, those data collected before and after the training of the CPOT to nurses were compared using the Wilcoxon test.

Results: Findings showed that the CPOT could not lead to improved nurses&apos function in relation to documentation of pain in the patients records (P=0.209) and recording palliative measures related to pain (P=0.117). However, there were significant statistical differences between nurses&apos function in relation to reassessment of pain after palliative intervention, before and after the training and application of the CPOT. Comparing the mean function scores before and after the intervention, demonstrated that the performance of nurses in this area has been improved after the intervention.

Conclusion: The critical-care pain observation tool can increase nurses&apos sensitivity to pain in patients with decreased level of consciousness. It forces the nurses to reassess the pain after palliative intervention. This tool does not motivate in nurses to document pain palliative process. So it is recommended that future studies investigate the impact of this tool on other aspects of pain management, such as diagnosis of pain and using of drugs and non-drug measures.

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Background & Aim: Asthma is one of the most prevalent chronic diseases worldwide. About 6.5 million people suffer from asthma in Iran. The Effective strategy to control asthma is related to education. The self-management has a major role in the standard education program. This study aimed to assess the effect of education on using peak flow meter and follow up via SMS on asthma self management.

Methods & Materials: This study was a quasi-experimental controlled clinical trial. The samples included 98 patients, suffering from asthma referred to the pulmonary clinic in Imam Khomeini and Shariati hospitals. Patients were selected using convenient sampling method and were randomly assigned into the experiment (n=47) and control (n=51) groups through blocking method. Two educational sessions were held in the experiment group about how-to-use peak flow meter. Accordingly, the patients in the experiment group sent their peak flow rates via SMS to the researcher within 12 weeks. The researchers provided feedback to the patients about their asthma control via phone, weekly. Patients in the control group did not receive any education. Data were collected using the Asthma Control Test before and three months after the intervention. Data were analyzed using the statistical tests of Chi-square, Mann-Whitney, Independent t-test and Kolmogorov-Smirnov.

Results: There was a significant statistical difference between the two groups of experiment and control in terms of asthma control (P=0.002).

Conclusion: The education using peak flow meter and following up via SMS promotes asthma self-management. With regard to the significant role of nurses in patient education, educating patients with asthma by nurses is recommended at the Iranian Society of Asthma and Allergies clinics and medical centers.

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Background & Aim: Poor sleep quality is a common problem among patients hospitalized in the CCUs. This study aimed to determine the effect of environmental factors modification strategies on quality of sleep among patients admitted to CCU.

Methods & Materials: This was a quasi-experimental study with a single-blinded design. Sixty patients admitted to the CCU of Shariati hospital were divided into two experiment and control groups. Sleep quality was measured in the first day of admission and three days later using the Pittsburgh sleep quality index in both groups. In the intervention group, we implemented a modified work environment between the two measurements. Data were analyzed using the Chi-squared and t-test in the SPSS v.18.

Results: Findings showed a significant decrease in sleep quality in the control group after hospitalization, compared with the intervention group (P<0.001). There were no statistically significant changes in the sleep quality before and after hospitalization in the intervention group (P=0.053).

Conclusion: Using environmental factors mitigation strategies can improve sleep quality of patients admitted to CCUs.

 

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  Background & Aim: The ventilator associated pneumonia is a common problem in critical care units. It is associated with increased mortality, cost and length of stay. Nurses have great role in preventing the ventilator associated pneumonia. The aim of this study was to assess nurses' performance in prevention of ventilator associated pneumonia .

  Methods & Materials: In this descriptive study, 110 nurses working in selected hospitals affiliated to Tehran University of Medical Sciences were selected using convenience sampling method. A 32-item observational checklist was provided based on the ventilator associated pneumonia prevention guideline. The nurses' performance was observed three times. Data were analyzed using descriptive statistics in the SPSS-16 . 

  Results: This study showed that the mean score of the nurses' prevention was 46.8±5.79. Most of the nurses (66.4%) had poor performance and 36.6% had relatively good performance. There were no nurses with favorable performance in the prevention of ventilator associated pneumonia. The highest score was in contact precaution (72±9.67) and the lowest score was in mouth hygiene (18.78 ± 17.4) .

  Conclusion: The majority of nurses had poor performance in prevention of ventilator associated pneumonia. More attention should be paid for planning appropriate training programs for nurses and giving adequate facilities to improve health care quality .

  

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  Background & Aim: Medication usage is the bases of disease management in patients who undergo hemodialysis. Non-adherence to medication regimen increases the incidence of complications among the patients . The aim of this study was to investigate the effect of a cognitive-behavioral intervention on medication adherence in patients undergoing hemodialysis .

  Methods & Materials: In this clinical trial, 70 patients were selected from Imam Reza and Valiasr hospitals. Patients were assigned into two intervention (n=35) and control (n=35) groups. The intervention group received a cognitive-behavioral intervention including six steps: 1) Identifying the problem 2) Creating confidence and commitment 3) Increasing awareness of behavior 4) Developing and implementing the action plan 5) Evaluating the plan and 6) Maintaining the desired behavior. Adherence to medication regimen was assessed using a self-report questionnaire before and immediately after the intervention. Data were analyzed using the independent t-test . 

  Results: At baseline, there was no significant difference in adherence to medicine regimen between the intervention (20.77 ± 4.56) and control (22.34 ± 3.65) groups (P=0.1). After the intervention, significant difference was observed between the two groups in adherence to medication regimen (P<0.001) .

  Conclusion: Cognitive–behavioral intervention could improve medication adherence in patients undergoing hemodialysis. It is recommended for nurses to use this approach to improve medical care among the patients .

  

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Background & Aim: Considering the importance of communication skills in nursing, we aimed to study the impact of online support and e-content on communication skills of nurses with patients.
Methods & Materials: In this quasi-experimental study with pre- and post-design, 100 nurses employed in the orthopedic wards of Chamran hospital affiliated to Shiraz University of Medical Sciences in 2018 were selected randomly and assigned into two groups of 50. Both groups received the electronic content of communication skills. In the intervention group, in addition to receiving educational content, online support was provided through social media for four weeks with the presence of a psychologist, so that by asking real questions and problems or simulated scenarios, appropriate behavior in that situation was discussed. Before and eight weeks after the intervention, communication skills in the both groups were assessed by the Burton Jay's Communication Skills questionnaire, and data was compared using independent t-test and analysis of covariance.
Results: The results showed that there was no significant difference between the two groups in the communication skills score before the intervention, but eight weeks after receiving the e-content, the participants' scores increased in the both groups. This increase was greater in the online support group (P<0.001). In fact, online support caused a difference (0.637) in the communication skills score between the two groups.
Conclusion: The results of this study showed the provision of e-content along with online support has led to the improvement of communication skills. It is recommended that in addition to education through e-content, social media be used in the empowerment programs of the treatment team including communication skills improvement, due to their advantages such as ease of use, availability and relatively low cost.
Clinical trial registry: IRCT20090127001599N27