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Nursing and Midwifery Studies - Volume:7 Issue: 3, Jul-Sep 2018

Nursing and Midwifery Studies
Volume:7 Issue: 3, Jul-Sep 2018

  • تاریخ انتشار: 1397/05/10
  • تعداد عناوین: 5
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  • Elahe Aghaziarati Farahani, Manijeh Nourian, Farzane Ahmadi, Mohammad Kazemian Pages 93-99
    Background
    Environmental lighting can potentially affect weight gain and the length of stay in Neonatal Intensive Care Unit (NICU) among premature neonates. Yet, there are controversies about the best way of lighting in these units.
    Objectives
    The aim of this study was to compare the effects of cycled lighting (CL) and constant lighting on weight gain and the length of stay in NICU among premature neonates.
    Methods
    This two-group randomized controlled trial was conducted on 78 premature neonates hospitalized in NICU of Mofid Children's Hospital, Tehran, Iran. Neonates in the intervention group were treated, for 15 days, with CL. Neonates in the control group were exposed to constant lighting of the unit. Neonates in both groups were weighed every morning at 07:30 and their length of stay in the unit was recorded in days. Data analysis was done through Chi-square test, independent-samples t-test, and Mann–Whitney U-test and the two-way analysis of variance. The random-effects spline model was employed to compare the groups in terms of the trend of weight variations over time.
    Results
    Neonate's weight in both groups decreased during the first 7 days of hospitalization and then started to increase from the 8th day. The groups did not significantly differ from each other respecting neonate's weight in the first 8th days (P = 0.857), while weight mean in days 9–15 in the intervention group was significantly greater than the control group by at least 25.25 g in the 9th day and 159.95 g in the 15th day (P
    Conclusions
    CL is effective in improving premature neonate's weight gain but ineffective in shortening their stay in NICU.
    Keywords: Length of stay, Light–dark cycle, Neonatal, Intensive Care Unit, Premature, Infant, Weight gain
  • Somayeh Nejadbagheri, Habibollahe S. Hosseini, Majid Kazemi Pages 100-104
    Background
    In each hemodialysis session, hemodialysis patients undergo two vascular punctures with large-diameter needles, which are associated with great pain. The reduction of puncture pain helps these patients accept hemodialysis and enhances their quality of life.
    Objective
    The present study was conducted to assess the effects of Arnigol cream on the pain associated with arteriovenous fistula puncture.
    Methods
    As a double-blind single-group randomized clinical trial, the present study was made on 71 hemodialysis patients. Each patient received an arterial and a venous fistula puncture. One puncture site was randomly allocated to the experiment and the other one to the placebo. Before needle insertion, the experiment and the placebo sites were treated for 10 min with 5 ml of Arnigol cream or Vitamin A and D ointment, respectively. After needle insertion, pain intensity at puncture sites was assessed using a visual analog scale. The data were analyzed using the paired-sample t-test.
    Results
    Participants were 71 hemodialysis patients, 49.3% were female. The mean of participant's age was 56.86 ± 15.10 years, with a range of 22–82. The length of receiving hemodialysis ranged from 4 to 96 months with a mean of 40.36 ± 22.79. Diabetes mellitus was the major cause of renal failure among participants (56.3%). The intensity of pain at the experiment site was significantly lower than the placebo site (2.83 ± 1.60 vs. 3.46 ± 1.57; P = 0.006).
    Conclusions
    This study showed the effectiveness of Arnigol cream in reducing the pain associated with arteriovenous fistula puncture among patients receiving hemodialysis. Thus, nurses are recommended to use this simple, safe, and inexpensive modality to reduce fistula puncture pain.
    Keywords: Arnigol, Hemodialysis, Fistula, Pain management, Puncture pain
  • Masoumeh Akbari, Sevilay Senol Celik Pages 105-110
    Background
    Coronary artery bypass graft (CABG) surgery is associated with different postoperative problems such as lengthy rehabilitation period and decreased quality of life (QOL).
    Objective
    This study aimed to investigate the effects of discharge training and postdischarge counseling on QOL after CABG.
    Methods
    This quasi-experimental study was carried out on a convenience sample of 100 patients who underwent CABG surgery in Seyedoshohad Heart Hospital, Urmia, Iran. Using a nonrandom assignment technique, patients were allocated to a control and an intervention group. Patients in the intervention group were provided with an educational booklet as well as discharge training and postdischarge counseling. Training and counseling services continued up to 6 weeks after hospital discharge. Patients in the control group only received routine discharge and postoperative services. The 36-item Short Form Survey was used to measure QOL both in the admission day and 6 weeks after hospital discharge. A home follow-up form was also completed for all patients 2 and 10 days and 6 weeks after hospital discharge. The data were analyzed via the paired-sample t, independent-sample t, Chi-square, Fisher's exact, Mann–Whitney U and Wilcoxon signed ranks tests.
    Results
    The baseline mean scores of QOL in the control and the intervention groups were respectively 46.89 ± 11.91 and 46.53 ± 15.04, with no between-group difference (P = 0.90). Six weeks after hospital discharge, the mean score of QOL in the intervention group was significantly greater than the control group (93.19 ± 4.45 vs. 47.00 ± 13.43; P
    Conclusions
    Discharge training and postdischarge counseling are effective in improving postoperative QOL among patients who undergo CABG surgery.
    Keywords: Coronary artery bypass, Counseling, Discharge planning, Aftercare, Patient education, Quality of life
  • Fatemeh Darsareh, Shahla Nourbakhsh, Fateme Dabiri Pages 111-115
    Background
    Water immersion during labor is increasingly being used in different medical facilities worldwide.
    Objective
    This study aimed to determine the effects of water immersion during the first stage of labor on labor outcomes.
    Methods
    This randomized controlled clinical trial was carried out from January to October 2015, in the labor and delivery ward of Khaleej-e Fars Hospital, Bandar Abbas, Iran. In total, 180 women were randomly allocated to a control group to receive routine care services and to an experimental group to receive water immersion during labor along with routine care services. The midwifery staff of the study setting regularly assessed uterine contractions, performed vaginal examinations, and monitored fetal heart rate. The length of the active phase of labor was measured in minutes as primary outcome. The independent-sample t and Chi-square tests were performed for data analysis.
    Results
    The length of the active phase of labor in the experimental group was significantly greater than the control group (232.95 ± 20.76 vs. 165.81 ± 22.76 min; P 0.05).
    Conclusions
    Water immersion during labor significantly prolongs the first stage of labor and significantly improves parturient women's satisfaction with the birth experience.
    Keywords: Delivery, Obstetric, Labor, Water
  • Hamideh Yazdi Moghaddam, Zahra-Sadat Manzari, Abbas Heydari, Eesa Mohammadi, Ibrahim Khaleghi Pages 116-121
    Background
    Caring for brain-dead patients is one of the hardest duties for nurses, particularly in Intensive Care Units (ICUs).
    Objective
    This study aimed to explore the nursing challenges of caring for patients diagnosed with brain death.
    Methods
    The present study was conducted as a qualitative conventional content analysis, and data collection was carried out by field notes and 15 semi-structured and in-depth interviews with nurses working in the ICUs. Data analysis co-occurred simultaneously with data collection.
    Results
    Seven themes were extracted from the data: uncertainties and conflicts between physicians and nurses, tensions in breaking the news of patient's brain death to families, stressful experience of caring for the first time, nurse's physical and psychological afflictions due to complex care tensions, stress of being blamed by patient's family, difficulty in tackling the emotions of patient's family, and finally, a sense of lack of support and protection in care. Finally, the main theme of turbulent confrontation with successive chains of tension in caring brain-dead patients was abstracted.
    Conclusions
    Since nurses confront chain of tensions while caring for a brain-dead patient, this can affect the quality of this vital role to keep the transplantable organs viable; furthermore, authorities should implement special support programs for nurses.
    Keywords: Brain death, Terminal care, Nurse, Qualitative research