فهرست مطالب

Evidence Based Care - Volume:6 Issue: 3, Autumn 2016

Evidence Based Care
Volume:6 Issue: 3, Autumn 2016

  • تاریخ انتشار: 1395/08/09
  • تعداد عناوین: 7
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  • Khadije Mirzaii, Shadan Nessari Ashkezari*, Talat Khadivzadeh, Mohammad Taghi Shakeri Pages 7-18
    Background
    Improvement of attitudes toward breast cancer positively affects the screening behaviors of women. Imagery has been shown to have a positive impact on the screening behaviors of women.
    Aim: This study aimed to investigate the effects of breast cancer screening training based on the systematic comprehensive health education and promotion (SHEP) model on the attitudes and breast self-examination skills of women.
    Method
    This quasi-experimental study was conducted at two urban healthcare centers of Mashhad, Iran in 2015. Participants were 120 women covered by these health centers, who received training on breast cancer screening based on the SHEP model. Intervention consisted of evaluation (literature review, topic selection), implementation (developing instruments, educator training, training of participants), and assessment (pretest-posttest). Data were collected using researcher-made questionnaires of attitude and breast self-examination (BSE) checklists. Data analysis was performed in SPSS version 20 using independent t-test and Mann-Whitney U test.
    Results
    In the intervention and control groups, 55 (91.7%) and 56 (93.3%) participants were married, respectively. Results of Mann-Whitney U test before intervention showed no significant differences between the groups regarding the mean scores of attitude and breast self-examination skills (P>0.05). After a four-week follow-up, independent t-test revealed a significant difference between the groups in terms of the mean score of attitude (PImplications for Practice: Considering the feasibility and applicability of the SHEP model for different age ranges, breast screening training based on this educational model could enhance the attitudes and performance of women in this regard.
    Keywords: Breast self, examination (BSE), Breast cancer screening, Systematic comprehensive health education, promotion model, Attitude
  • Mahdi Alimi *, Zahra Sadat Manzari, Seyed Reza Mazlom, Ahmad Bagheri Moghadam, Hossein Rouhani Pages 19-30
    Background
    Ventilator-associated pneumonia (VAP) is the most prevalent and lethal form of nosocomial infections in the ICU and oral disinfection is a nursing measure to prevent this condition.
    Aim: this study aimed to evaluate the effect of oronasal versus oral disinfections with chlorhexidine on the clinical criteria for diagnosis of VAP.
    Method
    This randomized clinical trial was conducted on 70 intubated ICU patients under mechanical ventilation at Shahid Kamyab Hospital of Mashhad, Iran in 2016. Samples were divided into two groups of intervention (mouthwash and disinfection of nostrils with 0.2% chlorhexidine every eight hours) and control (mouthwash). Clinical criteria for VAP, including pulmonary infiltration, rectal temperature, white blood cell (WBC) count and endotracheal discharge were recorded and compared between the two groups from days 1-6. Data analysis was performed in SPSS version 11.5 using Chi-square test.
    Results
    In this study, mean age of intervention and control groups was 44.3±19.9 and 45.9±18.2 years, respectively. The results of Chi-square test indicated no significant difference between the groups regarding rectal temperature (P=0.22), WBC count (P=0.33), purulent endotracheal discharge (P= 0.47), pulmonary infiltration (P=0.21) and incidence of VAP (P=0.21).
    Implications for Practice: According to the results of this study, no statistically significant difference was observed between the two groups regarding clinical criteria and the incidence of VAP despite clinical differences. Therefore, it is recommended that further studies be conducted in this area.
    Keywords: Ventilator, associated pneumonia, Mouthwash, Chlorhexidine, Mechanical ventilation
  • Haniyeh Jobrani, Nahid Aghebati*, Shirzad Shahriyari, Hamidreza Behnam Vashani, Sadegh Sehatbakhsh, Jamil Esfahanizadeh Pages 31-36
    Proper education and notification of patients undergoing heart valve replacement is of paramount importance. The past decade has witnessed a growing interest in the use of modern, advanced technologies in medicine and patient education. This study aimed to introduce an education-notification application for patients undergoing heart valve replacement. Research was carried out in two phases of software design and performance evaluation. The first phase consisted of two stages: development of educational materials and notifications befitting to the application and algorithm design. The second phase of the study involved the assessment of the viewpoints of 30 patients undergoing heart valve replacement using a researcher-made questionnaire. Validity and reliability of the questionnaire were confirmed using descriptive statistics and Mann-Whitney U test. According to the results, the designed education-notification software was described as “good” or “very good” by 81.3% (n=24) of the participants.
    Keywords: Design, Assessment, Education, notification software, Patients undergoing heart valve replacement
  • Monir Ramezani, Maryam Samimi Kalat*, Fatemeh Heshmati, Nabavi, Azadeh Saki Pages 37-44
    Background
    Patient education is taken into account as one of the key components of comprehensive care as well as one of the significant nursing functions in order to increase community health. In this respect, education materials and written texts can improve patient information up to 50% and consequently meet patient satisfaction. Readability is considered as an integral concept in patient education and an appropriate measure to determine how contents are perceived by readers.
    Aim: The present study was to measuring the readability level of patient education pamphlets in training hospitals in the city of Mashhad.
    Method
    This study was a descriptive research conducted in 2016. In order to measure the readability level, the Simple Measure of Gobbledygook (SMOG) Readability Test was used. The study sample included 543 patient education pamphlets used by 11 training hospitals in the city of Mashhad along with pamphlets developed by the Office of Vice-Chancellor for Treatment Affairs that were collected through the census method. The SPSS16 software was also employed for data analysis. In terms of descriptive analysis, mean and standard deviation were used. In addition, Cronbach’s alpha correlation test was employed for inferential analysis.
    Results
    The average readability level of patient education pamphlets was estimated equivalent to 11th grade (11.35±1.05). Moreover, the minimum and the maximum readability levels of the pamphlets were 9th grade and 15th grade, respectively.
    Implications for Practice: The results revealed that patient education pamphlets available in training hospitals in the city of Mashhad were endowed with a high level of readability. Thus, the given pamphlets were appropriate to patients with a level of literacy equal to senior university students and they could not be perceived by the public. Considering the importance of readability index in health promotion and increased patient self-care, it was recommended to improve the readability level of patient education materials.
    Keywords: Patient Education, Pamphlet, Readability, Readability Indices, Health Literacy
  • Seyed Hossien Ahmadi Hosseini, Marjan Farzad*, Abbas Heydari Pages 45-54
    Background
    Resistive Inspiratory Muscle Training (RIMT) is a well-known technique for rehabilitation of patients with Chronic Obstructive Pulmonary Disease (COPD). Incentive spirometry is another technique with potential viability for this application, but there is limited evidence in support of its efficacy in the rehabilitation of COPD patients.
    Aim: The objective of this study was to compare the effect ofresistive inspiratory muscle training and incentive spirometry on respiratory pattern of COPD patients.
    Method
    This study was a randomized clinical trial on 30 patients with moderate COPD who were referred, in 2011, to the pulmonary clinic of Emamreza Hospital of Mashhad (Iran). The patients were randomly divided into the RIMT and the IS treatment group. In both groups, exercise regimen consisted of two 15-minute sessions of exercise per day, in the morning and evening, four days a week for 4 weeks. Respiratory pattern (respiratory rate and depth) and dyspnea (at rest and during activity) were measured before and after exercise. Data was analyzed with the Mann-Whitney and ratio difference tests using SPSS v.11.5.
    Results
    The average age was 50.8±10.7 in the IS group and 51±10.8 in the RIMT group. The statistical tests found no significant difference between the groups in terms of post-intervention exertional dyspnea, dyspnea at rest, tidal volume, and respiratory rate (P>0.05); but post-intervention maximal inspiratory pressure and maximal voluntary ventilation in the two groups were found to be significantly different (P Implications for Practice: despite statistically superior performance of resistive training in improving the maximal voluntary ventilation and maximal inspiratory pressure, the difference between its results and the results of incentive spirometry is not clinically important, therefore positive clinical outcomes of incentive spirometry are sufficiently significant to encourage its use in COPD rehabilitation programs.
    Keywords: Incentive spirometry, Respiratory Pattern, Chronic Obstructive Pulmonary Disease, Resistive Inspiratory Muscle Training
  • Javad Malekzadeh, Mahboube Yazdani*, Alireza Sedaghat, Seyed Reza Mazlom Page 63
    Background
    Postoperative pulmonary complications (PPC) are of the major reasons for death. Prolonged mechanical ventilation (PMV) and delayed extubation are leading to the incidence of more seriously complications. The effect of hyperinflation has not been investigated in control of these complications in patients who have been weaned from mechanical ventilation and are undergoing T-tube support.
    Aim: Investigation of MHI effect on oxygenation of patients following abdominal surgery and T-tube support.
    Method
    This clinical trial was performed on 40 patients undergoing abdominal surgery and T-tube support hospitalized in intensive care units of hospitals in Mashhad, Iran, in 2015-2016. The participants were divided randomly into two experimental and control groups. In the experimental group, MHI technique was performed using Mapleson circuit for three twenty-minute periods. The control group received routine hospital care. The two groups were compared for PaO2, PaCO2 and SpO2 before intervention, 5 and 20 minutes after intervention. Data were analyzed using SPSS software.
    Results
    The mean age was 66.7±8.3 and 67.5±9.0 years in experimental and control groups, respectively. In intergroup comparison using independent t-test, the mean PaCO2, PaO2 and SpO2 had no significant differences in the experimental group before the intervention. However, the means SpO2 and PaO2 at 5 and 20 minutes after intervention were significantly higher in the experimental group (pImplications for Practice: The results showed that the MHI technique by increasing oxygenation and ventilation could improve lung function in the participants, resulting in shortening the duration of mechanical ventilation, accelerating the process of extubation, and thus faster patient recovery.
    Keywords: Lung Hyperinflation, Abdominal Surgery, Oxygenation, Postoperative Pulmonary Complications
  • Zeinab Kazemzadeh, Zahra Sadat Manzari*, Saeed Vaghee, Mahmood Ebrahimi, Sayed Reza Mazlom Pages 67-76
    Background
    The smokers who use supportive programs have a greater chance to quit smoking. Smoking cessation recommendation is one of the most important prevention and treatment methods mentioned in care guidelines provided for patients with acute coronary syndrome.
    Aim: The main objective of this study is to determine the effects of training-counseling programs on smoking cessation in patients with acute coronary syndrome.
    Method
    In this randomized controlled clinical trial, 51 patients with acute coronary syndrome in Ghaem and Imam Reza hospitals in Mashhad, 2015, after filling the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) questionnaire, were categorized into two groups. Intervention group received smoking cessation training-counseling program and control group received some advices/recommendations to quit smoking. After a three-month telephone follow-up, smoking cessation standard questionnaire was filled for all patients. The data were analyzed using SPSS v11.5 and Chi-square test.
    Results
    The age of study participants was 52.6± 7.9 and 56.2±12.3 for intervention and control group, respectively. According to Chi-square test, a significant difference was observed between intervention and control groups in first through fifth stages after the intervention in terms of succeed to quit smoking (pImplications for Practice: According to the findings of the study and given that the nurses are in the frontline of treatment process and also because they spend more time with patients and have a major impact on them, it is suggested to take advantage of the nurses to improve smoking cessation training-counseling programs regarding patients with acute coronary syndrome.
    Keywords: Cigarette, smoking cessation, training, counseling