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Background & Aim: Multiple sclerosis (MS) is characterized by a broad spectrum of physical and psychological impairments. Fatigue is a common and disabling symptom for individuals with MS 75%-90% of individuals with MS reported problems with fatigue. They describe fatigue as a frustrating and overwhelming symptom that can be disabling.

Methods & Materials: Assessing the usage and efficiencies of fatigue reducing strategies in patients referred to multiple sclerosis association of IRAN. This is a cross-sectional survey study of 100 patients who were selected randomly. The method of collecting data was by asking and answering and the research tool was a questionnaire. The questionnaire was prepared in four parts. Part one included the disease and demographic questions. Part two included Fatigue Severity Scale (FSS). Part tree included Fatigue Reducing Strategies and part four included Fatigue Relief Scale. The data were collected in one stage, and analyzed with SPSS software. To analyze the data, descriptive and inferential statistical methods (fisher exact test, chi square test, correlation coefficient, meant, standard deviation) have been used.

Results: The Findings of this study represented that the majority of subjects (63%) were suffering of severe fatigue symptom. The most frequently used strategies to relive fatigue were lie down (51%), watching TV (30%), frequent rest (28%) and sitting without doing any thing (28%). But the most effective strategies were sleeping (8.17), daily nap (8.4), take a shower with lukewarm water (7.25), avoiding heat (7.16), exercising (7.14), praying (7.0) and socialization (7.0). Results also showed that fatigue have been affected by some variables such as education level, having child, number of children, job status, daily working hours, dwelling place and time of bed-ridden. Findings also suggested that all strategies will be useful when the highest level of fatigue has been experienced (p=0.532, r=-0.063).

Conclusion: The most common strategies were not necessarily the most effective ones. Most frequently used strategies were included sleeping, napping, warm water bathing, heat avoidance, and exercising. However more physically active strategies such as exercise and socializing were more effective strategies. The patients should be suggested that to try variety of strategies such as walking and exercising besides sleeping and resting to relive the fatigue. Patients should be instructed to monitor the intensity of their fatigue and also be encouraged to maintain that level of activity which is in balance with efficient rest period.

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Background & Aim: Socio-economical changes have increased the women&aposs opportunity to take job in recent decades. The increased levels of women in work places, has resulted in a high interest in the potential adverse effects of work on pregnancy outcome. This study was conducted in order to surveying the association between occupational factors and preterm childbirth.

Methods & Materials: It is a cross-sectional study. Samples consisted of nurses and midwives (518 person) who working in Tehran&aposs universities of medical sciences hospitals. Also they delivered newborns in gestational age more than twenty weeks (term or preterm) in years 2001-2006. The subjects were selected using a multi stage sampling method. Data gathered using a self-administered questionnaire. Occupational factors labeled as fatigue score and working hours. The relation between Occupational factors and preterm birth was analyzed using descriptive and inferential statistics (Chi-squared, t-test and Mann-Whitney U test) by SPSS software.

Results: Based on the study findings, the prevalence of preterm labor was 17.2% (95%CI=0.14-0.20). Although the proportions of unfavorable working conditions include: working at acute clinical wards, standing up more than 3h per each working shift, physical exercise, working in cold or hot weather, working in busy environment with continuous noise, being checker of visual and aural monitoring signals, working hours equal or more than 40 hours per week, and working fatigue score equal or more than 3 were higher in preterm group but it didn&apost show any significant relation with preterm birth.

Conclusion: According to the research findings, it seems that occupational factors do not have explicit effect on preterm childbirth. Therefore more investigations are recommended.

 

Key words: Preterm Labor, Occupational Factors, Fatigue

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Background & Aim: Fatigue is a premature symptom in patients suffering from chronic obstructive pulmonary disease. This study aimed to determine effect of the home-based pulmonary rehabilitation on fatigue among patients with COPD.

Methods & Materials: In this clinical trial, 36 patients were recruited among from 100 patients with COPD according to inclusion criteria in Masih Daneshvari hospital in 2010. Participants were allocated into two control and intervention groups using random block sampling. In the intervention group, the pulmonary rehabilitation program was implemented during three educational sessions in three consecutive days. Fatigue was measured using the Fatigue Severity Scale (FSS) before and seven weeks after discharge. Data were analyzed using descriptive and inferential statistical tests (Independent and paired t-test, chi-square and covariance analysis).

Results: At baseline, the mean scores of fatigue were 47.11 and 47.50 in the experimental and control groups, respectively (P=0.902). After the intervention, the mean scores of fatigue reached 21.94 and 54.64 in the experimental and control groups, respectively (P<0.001).

Conclusion: According to results of the study, home-based pulmonary rehabilitation nursing could decrease fatigue in patients with COPD.

 

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  Background & Aim: Exacerbation of the symptoms among patients with chronic obstructive pulmonary disease is a part of the disease's cycle . Despite having medical treatments, most patients experience severe degrees of dyspnea. Self-management programs can help relieving the symptoms. T his study aimed to assess the effect of a self-management program on dyspnea and fatigue severity in patients with chronic obstructive pulmonary disease (COPD) .

  Methods & Materials: In this randomized clinical trial, 50 patients with COPD referred to Apadana clinic in Ahvaz were recruited into the study. Patients were randomly allocated to control and intervention groups. The intervention group received a self-management program designed based on the 5A model the control group did not receive any intervention. Patients were assessed using the Fatigue Severity Scale and the Borg Dyspnea Scale at baseline and three month later. The Chi-squared test and t-test were used to analyze the data . 

  Results: There was no significant difference between the two groups in fatigue severity at baseline. At the end of the three months, the fatigue severity score differed significantly between the two groups (P=0.004). There was also significant reduction in the patients' dyspnea in the intervention group than the control group after 12 weeks (P<0.001) .

  Conclusion: Our program was effective in reducing the COPD symptoms among patients. This simple and non-expensive program can be applied as a beneficial intervention to decline major difficulties of the disease among patients with COPD .

  

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Background & Aim: Patient monitoring in cardiac intensive care unit (CICU) is considered to be non-invasive and safe, but it can cause unintentional catastrophic consequences due to the alarm fatigue. The aim of the study was to determine the status of monitoring system alarms and nurses’ alarm fatigue.
Methods & Materials: This descriptive, cross-sectional study was carried out in cardiac intensive care units of a hospital in Fars province from January to March 2019. The alarm status of 24 monitoring devices was observed for 100 hours in 100 patients under the physiological monitoring. Patients under monitoring were included in the study using a continuous and convenience sampling. Also, 62 nurses working in five CICUs of this hospital completed the alarm fatigue questionnaire (through census). The data obtained from the observation and the questionnaires were analyzed by the SPSS software version 16 using descriptive statistics.
Results: The auditory alarms of monitoring devices were turned off and only visual alarms could be recorded. In the visual alarms recorded during 100 hours, 131 alarms (53.47%) were technical, followed by the false, nuisance, and ultimately real or actual alarms with rates of 40 (16.33%), 38 (15.51%) and 36 (14.69%), respectively. The mean (and standard deviation) score of alarm fatigue among nurses was 21.04 (7.52), and the alarm fatigue score for %50 of nurses was higher than the average score.
Conclusion: Turning off the auditory alarms can lead to serious risks to patients. Also, a high proportion of technical, nuisance, and false alarms can cause alarm fatigue in nurses. Adopting solutions in accordance with standard guidelines and checking physiological monitoring devices in hospitals are necessary in order to reduce false, nuisance, and technical alarms. Failure to pay attention to these issues leads to the alarm fatigue among nurses, which itself results in numerous consequences such as compromising the patients’ safety.
 

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Background & Aim: Fatigue and sleep disorders are the most common physical complaints in hemodialysis patients. It seems necessary to find effective, low-complication and cost-effective treatments to alleviate these problems. The aim of this study was to examine the effect of slow-stroke back massage on the level of fatigue and sleep quality in hemodialysis patients.
Methods & Materials: In this randomized controlled trial, 82 hemodialysis patients hospitalized in Shahid Beheshti hospital in Abadan in 2018, were selected based on the inclusion criteria and were allocated to either the intervention or control group using permuted block randomization (4 blocks). The intervention group underwent massage therapy for 12 sessions. The numerical rating scale for measuring fatigue and the Pittsburgh Sleep Quality Questionnaire were completed 14 times and three times respectively, by both groups. Data were analyzed through the SPSS software version 22 using descriptive statistical tests, independent t-test and repeated measures analysis of variance.
Results: The results showed that before the intervention, there was no statistically significant difference in demographic variables between the intervention and control groups (P>0.05). Significance of group and time interactions for fatigue score showed that the trend of changes in mean fatigue scores was different in the two groups and over the study time period (P<0.001). Also, there was a statistically significant difference between the two groups in the total score of sleep quality and all sleep components except two components (mental quality of sleep and sleep disorders) (P<0.05).
Conclusion: This study showed that slow-stroke back massage improves fatigue and sleep quality in hemodialysis patients. Therefore, it is recommended as an inexpensive, effective and uncomplicated method in hemodialysis patients.
Clinical trial registry: IRCT20181119041702N1