فهرست مطالب

نشریه پرستاری مراقبت ویژه
سال یازدهم شماره 2 (پیاپی 38، May 2018)

  • تاریخ انتشار: 1397/03/10
  • تعداد عناوین: 7
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  • Hamed Zare, Majideh Heravi-Karimooi *, Nahid Rejeh, Hamid Sharif Nia, Nader Noori Majelan Page 1
    Background
    Uremic pruritus is one of the most common causes of despair with debilitating potential in hemodialysis patients. The mechanism of uremic pruritus is still unclear. Although acceptable treatments are identified and available in this regard, further studies are required to find a reliable treatment.
    Objectives
    The present study aimed to determine the therapeutic effect of thermal therapy on uremic pruritus in patients undergoing hemodialysis.
    Methods
    This quasi-experimental study was conducted in 2017. A total of 40 hemodialysis patients who suffered from uremic pruritus were selected randomly and divided into two groups: one treated with heat (case) and the other with no intervention (control). The case group was exposed to far-infrared (FIR) radiation at 40°C for 15 minutes daily in 18 sessions.
    Results
    All criteria for evaluating uremic pruritus (the history of pruritus, the effect of pruritus on sleep, daily activities, quality of life, description of the sensational and emotional dimensions, and severity of pruritus) had a significant difference between the case and control groups (P
    Conclusions
    The effect of thermal therapy on reducing the severity of uremic pruritus showed that patients suffering from uremic pruritus could use thermal therapy as a complementary therapy for pruritus.
    Keywords: Hemodialysis, Quasi, Experimental, Thermal Therapy, Uremic Pruritus
  • Mahbobeh Ghasemi, Nahid Rejeh *, Majideh Heravi-Karimooi, Seyed Davood Tadrisi, Parvaneh Samady Kia Page 2
    Background
    Restless leg syndrome is an ordinary complaint among patients undergoing hemodialysis. Reflexology is a nursing intervention that can reduce the restless leg syndrome. This study aimed at investigating the effect of foot reflexology on the severity of restless leg syndrome in patients undergoing hemodialysis.
    Methods
    A randomized controlled trial with a before-and-after design was conducted in hemodialysis patients attending a hospital in an urban area of Iran in 2016. Using a random sampling method, 72 female patients were divided into the experimental and placebo groups (n = 36 in each group). The patients in the experimental group received foot reflexology. In the placebo group, simple foot reflexology without pressing certain parts of the foot was conducted. The restless leg syndrome questionnaire was used to measure the severity of restless leg syndrome before and after the intervention. Statistical analysis was performed using SPSS v. 21 software.
    Results
    After the intervention, the score of restless leg syndrome in the experimental group reduced compared to the placebo group (P = 0.02), while the group score of restless leg syndrome showed no statistically significant difference between the experimental and placebo groups (P = 0.84).
    Conclusions
    Foot reflexology can be used as a safe and non-pharmacologic nursing intervention in reducing the restless leg syndrome among female patients undergoing hemodialysis.
    Keywords: Foot Reflexology, Hemodialysis, Restless Legs Syndrome, Massage
  • Mahmood Motamedzadeh, Hosein Mahmoudi *, Abbas Ebadi, Batol Nehri Page 3
    Background
    Health care is inevitably associated with an increased risk of patient safety. Due to the complexity of attitude of care, the safety culture and the care of patients play a major role in safe care.
    Objectives
    The present study aimed to assess the quality of safe nursing care in the Cardiac Care Unit.
    Methods
    This is a descriptive study conducted in the Cardiac Care Unit of Baqiyatallah Hospital in 2018. All nursing staff working in the cardiac care unit comprised the sample of the study. Safe nursing care was measured using a tool designed by Rashvand et al. in 2015. Data were analyzed by SPSS version 21. This study was approved by the ethics committee in BMSU.
    Results
    The results showed that the majority of the research sample (55%) was male with an average age of 42.85 ± 9.66 years and a working experience of 19.05 ± 8.4 years. The mean score of the ethical dimension was 17.47 ± 1.92.
    Conclusions
    The results of this research can be used in educational planning at the undergraduate level of nursing to educate the students from the beginning of education, especially in the first semester, regarding patient safety, in particular, ethics, and safe care, in order to make it easier to use in the future and to reduce the need for in-service training programs. This develops safe care in healthcare settings.
    Keywords: Quality, Safe Care, Nursing
  • Junaidy Suparman Rustam, Waraporn Kongsuwan, Luppana Kitrungrote Page 4
    Background
    Comfort in patients receiving mechanical ventilation can be disturbed for many reasons. This condition may lead to negative impacts due to unmet comfort needs in patients with mechanical ventilation. Kolcaba’s comfort theory described that patients’ comfort may be enhanced, if the needs of comfort can be met in four contexts of comfort, including physical, psychospiritual, environmental, and sociocultural comfort. Therefore, there is a need to identify causative factors that may disturb comfort during mechanical ventilation and intervention to promote comfort while receiving mechanical ventilation.
    Objective
    This study aimed at reviewing the literature concerning comfort in patients receiving mechanical ventilation.
    Methods
    A literature review was conducted by analyzing 42 scholarly papers from year 2002 to 2016. The data were searched through Scopus, ProQuest, Elsevier/Science Direct, CINAHL, and PubMed based on PICO questions with keywords; ‘comfort’, ‘discomfort’, ‘comfort need’ ‘patient’, ‘mechanical ventilation’, and ‘ventilator’. Relevant articles were appraised following the recommendation of the Joanna briggs institute for evidence-based nursing.
    Results
    Overall, 116 articles were retrieved and 42 articles met the inclusion criteria. The results presented comfort needs of mechanically ventilated patients in physical, psychospiritual, environmental, and sociocultural contexts, and interventions to promote comfort during mechanical ventilation were divided to the following three categories, pharmacological interventions, nursing care interventions, and complementary and alternative interventions.
    Conclusion and Recommendation: The knowledge from this literature review can be useful for nurses and other healthcare providers to develop quality comfort care for patients dependent on mechanical ventilation
    Keywords: Comfort, Discomfort, Mechanical Ventilation, Ventilator
  • Elahe Momeni, Katayoun Alidostishahraki *, Mozghan Taebi, Mehdi Hoseini, Tanya Dahesh Page 5
    Background
    In obstetrics, pregnancy and childbirth are the basis for psychological and biological crises and are associated with a high prevalence of anxiety disorders. This study aimed to investigate the effectiveness of group psychological counseling on the level of pregnancy anxiety and fear of vaginal delivery in pregnant women.
    Methods
    This Quasi-experimental study was done in 2016 on 96 pregnant women (selected via multistage cluster sampling) that had low to medium levels of anxiety and had an average of 28 or higher fear scores from birth labor. The intervention group treated with 5 sessions of group psychological counseling pre-test and post-test were completed by each of the two groups. Independent and paired t-tests were used for analyzing.
    Results
    Results showed that the psychological counseling could reduce situational and trait anxiety in the intervention group (P
    Conclusions
    According to results, psychological counseling was effective in reducing pregnancy anxiety and fear of childbirth. Therefore, it is recommended that the findings were considered by nurses and other medical staffs to improve the health status of pregnant women
    Keywords: Psychology, Pregnancy, Anxiety, Vaginal Delivery
  • Esmail Heidaranlu *, Mohammad Pourebrahimi *, Masume Rashidi *, Nahid Aghdasi Mehrabad, Arman Zarbizadeh, Kosar Eftekhari, Mohsen Mollahadi, Morteza Moradi Faradonbeh Page 6
    Background and Objectives
    One of the common complications of open heart surgery is AF and PVC arrhythmias. Since the highest share of care and treatment in cardiac arrhythmias, especially in critical care departments, is done by nurses, and in order to increase awareness for better nursing care, the current study was designed to evaluate the effect of magnesium sulfate on the incidence of AF and PVC after open heart surgery.
    Methods
    In this semi-experimental study, 140 patients were randomly divided to intervention and control groups. Seventy patients (intervention group-magnesium sulfate) received 2 g of intravenous magnesium before surgery, 2 g during the operation, and 30 mg/kg on days one, two, three, and four after surgery, and 70 patients in the control group underwent surgery routinely. The serum level was measured before, during, and after the operation. Chi-square and Fisher’s exact tests were used to analyze the qualitative variables (P > 0.05).
    Results
    The incidence of postoperative atrial fibrillation in the intervention group was 1.4% and in the control group, this was 10% (seven patients). P was 0.02 and the incidence of premature ventricular contractions in the intervention group was 24.2% (17 cases) and in the control group, this was 51% (36 patients), P = 0.03.
    Conclusions
    Administration of magnesium sulfate before, during, and after open heart surgery seems to be useful in preventing new cases of atrial fibrillation and premature ventricular contractions. The results of this study can help improve nursing care in critical care departments.
    Keywords: AF, PVC, CABG, Magnesium Sulfate
  • Zahra Godarzi, Omolbani Rahimi *, Nasrin Khalesi, Farin Soleimani, Nooredin Mohammadi, Ahmad Reza Shamshiri Page 7
    Background
    The implementation of developmental care in neonatal intensive care unit (NICU) saves neonates’ energy and stabilizes their physiology, reduces stress in them and their family, and decreases hospitalization time and healthcare costs. The role of a neonatal nurse is crucial for an appropriate and successful execution of developmental care in NICU. This study was conducted to evaluate nurses’ opinions on barriers to effective implementation of developmental care in NICUs of Tehran University of Medical Sciences.
    Methods
    This was a cross-sectional study carried out on a total of 138 nurses who had a minimum work experience of six months in NICUs. Data collecting tool was a 12-point questionnaire including questions related to 5 core measures of developmental care according to Coughlin’s framework as well as questions associated with barriers based on a study by Wu. Descriptive and analytical statistics were used for data analysis.
    Results
    The mean age for 138 nurses was 31.76 ± 5.41 years (23 - 49 years). The mean work history in the NICU was 4.36 ± 3.58 years. Of all nurses, 79.7% were found to be familiar with developmental care practice. Among participants, 56.4% mentioned most part of their familiarity with developmental care; nurses mostly gained familiarity with developmental care via information exchange with nurse colleagues. The majority of participants described that inadequate time, inappropriate work environment in terms of space and equipment of NICU, and too many requests by parents were major barriers to deliver 5 core measures of developmental care in NICUs.
    Conclusions
    The implementation of developmental care was hampered by serious barriers.
    Keywords: Barriers, Developmental Care, Neonatal Intensive Care Unit (NICU)