فهرست مطالب

Medical - Surgical Nursing - Volume:7 Issue: 2, May 2018

Iranian Journal Of Medical - Surgical Nursing
Volume:7 Issue: 2, May 2018

  • تاریخ انتشار: 1397/02/15
  • تعداد عناوین: 4
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  • Davood Hekmatpou *, Mansoreh Karimi Kia Page 1
    Context: Fever is one of the most common problems in patients. There are a variety of fever control interventions with different levels of efficacy and side effects across patients, especially among critically ill individuals. In this regard, the current review study was conducted to examine the evidence regarding the nursing interventions used to control fever. Evidence Acquisition: For the current study, the articles on fever control methods were searched throughout several databases including SID, Irandoc, Google Scholar, PubMed, Medline, Scopus, Cochrane Library, and ScienceDirect. The search process was accomplished using the following keywords: “management of fever”, hyperthermia”, and “nursing intervention”. The electronic search was performed without any time limit. The exclusion criteria were the duplicate and incomplete studies, animal studies, the ones without clear statistical analysis, and those with a sample size of < 30 subjects (due to low statistical power).
    Results
    The electronic search resulted in the inclusion of 22 articles. In most of the studies, acetaminophen was introduced as the first choice of therapists to control fever. The adoption of physical methods to manage fever varied across different centers depending on the available facilities and hospital routines.
    Conclusions
    As the findings of the reviewed studies indicated, pharmaceutical and physical methods to manage fever should be selected according to patient’s conditions. It is recommended that a combination of physical and pharmaceutical interventions for this purpose be utilized. It is also suggested that proper protocols be presented for the appropriate treatment and management of fever under different conditions.
    Keywords: Febrile Patients, Fever, Care, Sponge Bath
  • Ali Raghibi , Alireza Salar*, Hassan Askari , Roghaieh Keykha Page 2
    Background
    Fistula needle insertion constantly exposes dialysis patients to pain, mitigation of which improves acceptance of hemodialysis and quality of life in these patients.
    Objectives
    Therefore, the present research was conducted to investigate the effect of Arnica ointment and distraction on the pain caused by fistula needle in hemodialysis patients.
    Methods
    This double-blind clinical trial was performed on 93 hemodialysis patients attending the dialysis wards of Ali Ibn Abi Talib and Khatam-al Anbia hospitals. The participants were chosen using the convenience sampling method and randomly assigned to three groups of Arnica ointment, distraction, and placebo. The pain intensity caused by arteriovenous needle insertion in two hemodialysis sessions was measured by visual analogue scale (VAS). Then, the collected data were analyzed by SPSS, version 22. P value less than 0.05 was considered statistically significant.
    Results
    We found a significant difference in pain intensity between the Arnica and placebo groups and between the distraction and placebo groups (P < 0.001). Further, pain intensity in the Arnica group was significantly lower than in the distraction group (P < 0.001).
    Conclusions
    Arnica ointment and distraction are palliative and convenient methods, which are even trainable to patients themselves. Considering the low cost of these methods, they are recommended to be applied before inserting the fistula needle.
    Keywords: Arnica, Distraction, Pain, Hemodialysis
  • Masoud Jamshidzahe Dejange , Fatemeh Kiani*, Seyed Mehdi Tabatabaei , Mojtaba Tasbandi Page 3
    Background
    Breast cancer is the most common type of cancer and the second leading cause of death after lung cancer and is associated with numerous complications, including anxiety. It seems that organized educational interventions, such as Orem's self-care model, decrease the incidence of complications, such as anxiety.
    Objectives
    Therefore, the aim of the present study was to determine the effect of the self-care training program based on Orem's model on anxiety of women with cancer undergoing chemotherapy.
    Methods
    The present research was a clinical trial study conducted on 70 women with breast cancer, who had referred to educational hospitals of Zahedan, during year 2017. The convenience sampling method was used and data was collected using a demographic questionnaire, the Orem's need assessment form, and the Spielberger State-Trait Anxiety Inventory (STAI). Data were collected at baseline and four weeks after the end of the last intervention session. The intervention group received training sessions (three 25- to 30-minute sessions) based on the Orem's model, on a weekly basis, yet the control group did not receive any intervention except routine care.
    Results
    The results of statistical tests showed no significant difference between the two groups in terms of distribution of demographic variables, such as age, marital status, level of education, number of children, and occupation. The results of statistical tests also showed a significant difference between pre- and post-anxiety levels in the intervention group and there was no such significant difference in the control group (P < 0.001). Moreover, the results showed a significant difference between the two groups in terms of pre- and post-anxiety changes (P < 0.001). The results of comparing the two groups showed a lower post-intervention anxiety level in the intervention as compared to the control group, although this difference was not significant regarding trait anxiety (P: 0.62) and state anxiety (P: 0.017).
    Conclusions
    Orem's self-care model-based training program can reduce anxiety among patients with breast cancer and can serve as a self-care model for nursing care interventions in these patients.
    Keywords: Anxiety, Breast Cancer, Orem's Self-Care Model
  • Hamed Sarani , Nezarali Moulaei , Ebrahim Ebrahimi Tabas , Enayatollah Safarzai *, Somayeh Jahani Page 4
    Background
    Although it is vital to prevent catheter-related infections (CRIs) as the most common cause of hospital infections, there is still no agreement on the best antiseptic agent.
    Objectives
    The aim of the present study was to compare the effects of chlorhexidine, alcohol, and alcohol-chlorhexidine solutions on local CRIs in patients admitted to coronary care units (CCUs).
    Methods
    This randomized double-blind clinical trial was performed on 150 patients admitted to the CCUs of the hospitals affiliated to Zahedan University of Medical Sciences, Iran, in 2017. The subjects were selected using the convenience sampling method and randomly divided into three groups of 50, including groups A (alcohol), B (chlorhexidine), and C (alcohol-chlorhexidine). The injection site was disinfected with 70% alcohol, chlorhexidine solution, chlorhexidine-alcohol solutions in groups A, B, and C at a radius of 5 cm from the center. Local CRIs rate was assessed based on results of a culture test. After removing the catheter from the vessel, the tip was separated with a scissor and transferred to the culture medium under sterile conditions. It was then sent to laboratory for microbiological evaluation, and the culture results were compared. In case of growth of more than 15 colonies in each plate, the colony was considered to be positive. Patients and laboratory experts who reviewed and reported the results of the culture were blind to the group allocations. Data were then analyzed by using Chi-square test and Fisher’s Exact test in SPSS, version 16.
    Results
    We found a significant difference between the three groups in terms of local CRIs (A: 20%, B: 22%, and C: 4%; P: 0.024). There was a significant difference between the chlorhexidine and alcohol-chlorhexidine groups (P = 0.007) and between the alcohol and alcohol-chlorhexidine groups in this regard (P = 0.014). The prevalence of local CRIs was significantly lower in the alcohol-chlorhexidine group than the alcohol and chlorhexidine groups.
    Conclusions
    Since the findings of the present research showed that skin cleansing with alcohol-chlorhexidine solution compared to alcohol and chlorhexidine could more effectively reduce local CRIs, it is recommended to use this formulation for disinfection of the intravenous catheterization site.
    Keywords: Disinfection Solution, Local Catheter-Related Infection, Peripheral Venous Catheterization, Alcohol, Chlorhexidine, Hospital Infection