فهرست مطالب

نشریه پرستاری مراقبت ویژه
سال یازدهم شماره 3 (پیاپی 39، Aug 2018)

  • تاریخ انتشار: 1397/11/15
  • تعداد عناوین: 7
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  • Mahdi Poornazari , Somayeh Mohammadi , Mostafa Roshanzadeh , Ali Tajabadi * Page 1
    Context: Nutrition support is part of the standard care in the intensive care unit. There is a paradox in the use of enteral and parenteral nutrition methods in ICU patients.
    Objectives
    The aim of this study was to compare the effects of enteral and parenteral nutrition methods in patients admitted to the ICU.
    Data Sources: This article is a narrative review. A total of 619 articles, were extracted during the years of 2000 - 2018, on nutrition methods in ICU patients, with keywords enteral nutrition, parenteral nutrition, and nutrition in critical patients in databases of internal (SID, Iran Medex, Medlib) and external publications (PubMed, Scopus, Web of Science, Google Scholar); finally, 19 articles were analyzed.
    Results
    Enteral administration reduced the associated infectious morbidity, hospitalization time, mortality, costs, non-infectious complications, multiple organ failure, systemic infections, local septic complications, and the need for surgery. It also causes early returning of intestinal movements, faster preoperative weight gain, easier fluid and electrolyte management, reduction of hyper metabolic responses, more complete nutrition, preservation of the gastrointestinal mucosa, and the ability to complete the program by the patient. Parenteral nutrition increases infectious complications, hyperglycemia, coagulation disorders and duration of hospital stay, as well as effects on invasive ventilation.
    Conclusions
    Enteral nutrition is safer and less complicated. By improving the awareness of careers through education, patients can be improved faster.
    Keywords: Enteral Nutrition, Intensive Care Unit, Parenteral Nutrition
  • Zahra Saiednejad , Neda Mirbagher Ajorpaz , Mohammad Aghajani * Page 2
    Background
    End-stage renal patients conformed to a variety of physical and psychological problems. Self-efficacy is regarded as an essential component to achieve a desirable condition in these patients. The aim of this study was determined the effectiveness of empowerment program based on the BASNEF model on the self-efficacy of patients under hemodialysis.
    Methods
    The present study was a randomized, single-blind, parallel, controlled clinical trial that was performed on 60 patients who referred to the Hemodialysis Centre of Kashan University of Medical Sciences, Iran. Participants were assigned to two groups based on block randomization allocation. The intervention group (n = 30) received 8 sessions of empowerment program and the control group (n = 30) received the routine cares for 4 weeks. Data were collected by a Sherer's general self-efficacy questionnaire at baseline and end of study and analyzed using Chi-square, independent and paired t-test in SPSS 13v.
    Results
    The study was completed by 58 participants. However, as the analysis was based on an intention-to treat approach, all 60 patients were included in the final analysis. Comparison of the two groups showed that the total scores of the self-efficacy were increased after intervention (65.86 ± 16.42 vs 50.3 ± 18.02, t = 3.24, P < 0.002). In addition, significant difference was observed between the mean score of self-efficacy in the intervention group prior to and after the empowerment program (P < 0.0001), while no significant change was observed in the control group, before and after the study (P = 0.17). No harms and side effects associated with intervention were in the groups.
    Conclusions
    The empowerment program was effective on self-efficacy of patients with end-stage renal diseases undergoing hemodialysis. Therefore, it is recommended that this program be used to increase self-efficacy in medical settings.
    Keywords: Behavioral Model, Empowerment, Self-Efficacy, Hemodialysis
  • Ahmadreza Baghernezhad, Mahin Adeli, Elham Sepahvand * Page 3
    Background
    Full Outline of Unresponsiveness (FOUR) scale is a strong predictor of hospital patients’ mortality, survival rate, and prognosis.
    Objectives
    The aim of this study was to compare FOUR and GCS scores in predicting in-hospital mortality in cerebrovascular accident (CVA) patients admitted to intensive care units.
    Methods
    A total of 197 CVA patients were enrolled in this prospective study. Each patient was evaluated with FOUR and GCS. The area under the ROC curve was determined for in-hospital mortality outcomes.
    Results
    The mean age of the patients was 71.00 ± 12.68 years, and 64% were male and 36% were female. The sensitivity of FOUR and GCS was 94.12% and 90.59% respectively. The area under the ROC curve was 0.841 for FOUR scale and 0.815 forGCS.
    Conclusions
    The results of our study showed that FOUR scale is a functional tool for evaluating and predicting in-hospital mortality in CVA patients, and it enjoys high sensitivity and specificity. However, further studies are warranted.
    Keywords: Cerebrovascular Accident, FOUR Score, GCS, Intensive Care Unit
  • Arezoo Safaei Nezhad , Forouzan Akrami , Leila Rastegari , Roghieh Kharaghani * Page 4
    Background
    One of the most important indices of health planning and policymaking in every country is the distribution and leading causes of mortality.
    Objectives
    This study was conducted to determine the prevalence of stillbirth and it’s maternal, fetal, and delivery risk factors in Zanjan province during 2014 - 2015.
    Methods
    The study was descriptive-analytical research. The electronic birth registration form, which is used to collect delivery data in Iran, was used for data collection. Data were analyzed using descriptive, univariate, and multivariate regression tests.
    Results
    The incidence of stillbirth was 10 per 1000 births and consistent with the country’s rate. There was a significant correlation between stillbirth and gestational age, birth weight, anomalies, vaginal delivery, outside hospital delivery, delivery complications, episiotomy, and labor induction and augmentation.
    Conclusions
    It seems that changing modifiable factors such as the place of delivery, type of delivery, and labor interventions can prevent stillbirth more effectively.
    Keywords: Prevalence, Risk Factors, Stillbirth, Zanjan
  • Nafiseh Abolfathi , Abolfazl Rahgoi , Mehdi Rahgozar , Asghar Dalvandi * Page 5
    Background
    Stroke is one of the major causes of inability in adults and the elderly. The chronic complications and the problems resulting from this disease have significant effects on the quality of life of these patients and result in diminished self-efficacy of the affected individuals. The present research was conducted with the aim of determining the effect of self-efficacy training on the quality of life and self-efficacy of patients with stroke.
    Methods
    This is a quasi-experimental study with a control group. The study population included ischemic stroke patients among which, a sample of 80 people were chosen according to the inclusion criteria through a convenience sampling method. They were then assigned randomly into intervention and control groups (40 subjects each). For the intervention group, a training program based on the self-efficacy model was presented in five sessions, but in the control group, only routine hospital cares were provided. In order to collect data, the stroke-specific quality of life scale, whose validity and reliability were measured and confirmed, was used. The data were analyzed by SPSS 16 at descriptive and analytical statistical levels (independent t test, paired t test, and analysis of variance).
    Results
    The findings indicated that there was no significant difference in the quality of life between the two groups before the training (P > 0.005). However, following the training, a significant difference was observed in the quality of life of patients with stroke between the intervention and control groups (P < 0.005). The results of this research indicated that the quality of life and its components in stroke patients had a greater mean value following training in the intervention group than in the control group.
    Conclusions
    Implementing self-efficacy training programs can result in the enhanced quality of life and self-efficacy among patients with stroke. Since the promotion of self-efficacy in patients with chronic disease is important, it is suggested that educational programs are also held for other patients with chronic diseases.
    Keywords: Patients, Stroke, Quality of Life, Self-Efficacy
  • Ali Kamali, Fatemeh Mashayekhi * Page 6
    Background
    Pain is an interesting sign of life. It is a wonderful phenomenon that often serves to save man’s life. Pain management is one of the most important aspects of patient care and nurses play a crucial role in this regard. Therefore, it is very important that caregivers have sufficient knowledge of pain management.
    Objectives
    The aim of this study was to survey the effect of training on knowledge and attitude toward pain management among nurses working in hospitals affiliated to Jiroft University of Medical Sciences in south of Iran.
    Methods
    This was a quasi-experimental study.
    Results
    A significant difference was found between knowledge and attitude scores obtained before and after training on pain management (P = 0.000). Scores showed a significant increase after training in terms of knowledge and attitude toward pain management among nurses.
    Conclusions
    Results showed that training had a significant effect on nurses’ knowledge and attitude toward pain management; therefore, it is necessary for them to receive continuous training on how to manage pain.
    Keywords: Education, Knowledge, Attitude, Nurses, Pain Management
  • Ehsan Kashani , Hadiseh Monadi Ziarat , Ali Tajabadi * Page 7