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Background & Aim: High frequency of traumatic and non-traumatic brain injuries in one hand and improvement of the health care condition to restore patient&aposs life in the other hand has increased the frequency of comatose patients in ICU. These patients often experience physical, cognitive, behavior or sensory defects, and the sensory input reduction in intensive care units expose them to cognition disorders. It seems that using sensory stimulation programs may be effective in preventing from sensory deprivation and facilitating recovery process.

Methods & Materials: In this quasi-experimental study, 30 comatose patients who were hospitalized in ICU in Shariati and Sina hospitals were sought to be studied. The subjects were selected randomly using matching that was placed in case and control group. In the intervention group, patients received an auditory stimulation for 2 weeks, 6 days of a week, 2 times a day. The auditory stimulator was a recorded tape (5-10 minutes) of a familiar voice for 30 minutes. The Glasgow Coma Scale (GCS) was used for measuring the level of consciousness (LOC). LOC was measured before and after each intervention 4 times a day. The control group LOC was measured in a similar manner to the case group. At the same time, homodynamic symptoms (blood pressure, pulse rate, and mean arterial pressure) were measured. Non-parametric test was used for analyzing data. The data was analyzed through SPSS V.11.5 computer software.

Results: The findings indicated that there was a significant difference in LOC of the intervention group at the first day and after fourteen days of the intervention (P<0.001), but not in the control group (P=0.769). Although 2 groups were similar in LOC of the first day (P=0.605) but there were a significant difference between their LOC at the fourteenth day (P=0.001).

Conclusion: The results showed that the auditory stimulations with familiar voice were effective in increasing LOC in the comatose patients. It is suggested that nurses expose comatose patients with auditory stimulations using a recorded tape of familiar voice in ICU.

 

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Background & Objective: The mortality rate of pneumonia caused by mechanical ventilation is about %25-30. Pneumonia prolongs length of stay in hospital to more than 13 days. There are various approaches to decrease rate of pneumonia in medical wards. The aim of this study was to assess the effect of planned passive respiratory exercise on prevention of pneumonia in coma patients undergo ventilation.

Methods & Materials: In this quasi-experimental study, 76 patients were assigned into two experimental and control groups. The control group (n=38) received usual care in the ICU. The experiment group (n=38) received planned respiratory care within six days. The procedure was done in five minutes/six hours for a three day period and then in 10 minutes/six hours for the next three days. Laboratory tests were done before the intervention and in the third and sixth days of the intervention. The respiratory care planning included respiratory passive exercises along with the common respiratory care.

Results: The results indicated that there were significant differences in the results of lab tests between two groups after the intervention (P<0.0001).

Conclusion: The results of this study showed that planned respiratory care had positive effect on prevention of respiratory infection in coma patients.

 

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Background & Aim: Decreased level of consciousness is one of the life-threatening complications associated with brain injuries. The aim of the study was to explore the effect of auditory and tactile stimulation by a family member on patients’ consciousness level.
Methods & Materials: This quasi-experimental study was conducted on 80 comatose patients with traumatic brain injury hospitalized in the intensive care units of Zahedan educational hospitals in 2019. Samples were selected by the convenience sampling methods and then randomly divided into experimental or control groups. Data collection tool included a demographic information questionnaire, and FOUR criteria for the level of awareness. For the experimental group, the intervention including auditory and tactile stimulation was performed by a family member for 10 minutes for seven consecutive days. The control group received routine interventions. To analyze the data, descriptive and inferential statistical tests (independent t-test, paired t-test, analysis of covariance, chi-square and repeated measures ANOVA) were used through the SPSS software version 21.
Results: The results indicated no significant differences in the level of consciousness between the two groups on the first and fourth days. Yet, independent t-test, analysis of covariance and repeated measures ANOVA showed that the intervention group had significantly a higher level of consciousness on the fifth, sixth and seventh days compared to the control group (P<0.001).
Conclusion: Findings showed that auditory and tactile stimulation by a family member is effective in increasing the level of consciousness in comatose patients with brain injury. So, this technique is recommended as an intervention in nursing care to increase the consciousness level in these patients.