Evidence Based Care
Volume:5 Issue: 3, 2015

Gestational diabetes (GA) is a common complication، associated with adverse prenatal outcomes and perceived stress. The effects of education on perceived stress have been widely investigated، whereas the role of self-care in GA has been less noted. to determine the effects of self-care education on perceived stress in women with GA under insulin treatment. In this randomized controlled trial، 60women with GA under insulin treatment (at 24-30 weeks of gestation)، referring to the diabetes clinic of Mashhad Omolbanin Hospital، were divided into intervention and control groups in 2014. Self-care education included four one-hour sessions (one-week intervals) in groups consisting of 6-8 members. The researcher-made self-care questionnaire and Cohen’s Perceived Stress Scale were completed before and four weeks after the intervention. Independent t-test، Mann-Whitney and covariance analysis were performed، using SPSS version 16. The mean age of the participants was 32. 4±0. 5 years in the intervention group and 31. 4±4. 8 years in the control group. Before the intervention، the perceived stress score in the intervention group (27. 6±8. 0) was not significantly different from that of the control group (27. 5±6. 8) (P=0. 74). However، after the intervention، the scores significantly reduced in the intervention group (23. 4±8. 3)، compared to the control group (28. 1±7. 5) (P<0. 001). Self-care education might improve self-care and reduce perceived stress in patients with GA. Therefore، self-care is suggested as an effective method for reducing stress in these patients.

Chronic diseases in children lead to failure in the development of self-esteem and productivity. Self-efficacy decreases as one’s behaviors become more complex and difficult to deal with. Storytelling is an observational learning method، which is effective in improving self-efficacy.

to determine the effects of storytelling on self-efficacy in children with thalassemia (aged 7-12 years) in Mashhad، Iran.

In this randomized clinical trial، 60 children with thalassemia، referring to Sarvar Pediatric Hospital of Mashhad in 2014، were randomly divided into control (usual care) and intervention (storytelling) groups. In the intervention group، storytelling was performed during eight sessions (60 min each)، whereas the control group received routine care. The samples completed the Self-Efficacy Questionnaire for Children by Morris (2002) before the intervention، immediately after the intervention and after one month. For data analysis، independent t-test and repeated measures ANOVA were performed، using SPSS version 14.

In the intervention group، 60. 0% of subjects were female and the mean age was 9. 4±1. 9 years. In the control group، gender distribution was equal and the mean age of participants was 9. 5±1. 8 years. Based on the repeated measures ANOVA، self-efficacy and educational self-efficacy were significantly different between the two groups during three stages of evaluation (P>001).

The obtained results highlighted the effectiveness of storytelling in general and educational self-efficacy of children with thalassemia. This study introduced storytelling as an interesting technique for attracting children to baby-friendly hospitals.

Poor neonatal resuscitation can lead to death or irreversible consequences in newborns. Therefore، proper training using suitable techniques and continuous practice are of pivotal importance. to compare the effects of video-assisted debriefing and educational workshops on the quality of neonatal resuscitation. In this semi-experimental three-group study، 90 cases of resuscitation were recorded at Omolbanin Hospital of Mashhad، Iran during February 2014-January 2015. The cases were divided into debriefing، educational workshop and control groups. In the first stage، 30 cases of resuscitation were recorded in the control group. In the second stage، the resuscitation team participated in educational workshops، and finally، debriefing classes were held. Thirty cases of resuscitation were recorded and evaluated، using a resuscitation quality assessment checklist، based on Neonatal Resuscitation Program (NRP) -2011. For data analysis، Chi-square، ANOVA and Kruskal-Wallis tests were performed، using SPSS version 11. 5. In total، 55 (61. 1%) newborns were males and the mean gestational age was 37. 2±4. 2 weeks. The resuscitation quality score was higher in the debriefing group (40. 9±12. 1)، compared to the workshop (19. 6±11. 7) and control (14. 3±9. 9) groups. The difference was significant between debriefing and workshop groups، as well as debriefing and control groups (P<0. 001). However، no significant difference was observed between the control and educational workshop groups (P=0. 17) Video-assisted debriefing was more effective in improving neonatal resuscitation، compared to educational workshops. Therefore، this method is recommended for neonatal resuscitation training at hospitals.

Cancer as one of the chronic diseases in children is associated with psychological problems. Utilization of low-risk and cost-effective methods (e. g.، play therapy) for controlling emotional distress seems necessary in children. to determine the effects of structured cognitive-behavioral group play on anxiety and depression in children with cancer. In this quasi-experimental pretest-posttest study، 18 children (8-14 years old) with cancer، hospitalized at Dr. Sheikh Hospital of Mashhad، were selected via available sampling and were randomly allocated into control and intervention groups in 2014. The intervention group received 10 sessions (60 min) of structured cognitive-behavioral group play therapy. Both groups were assessed by the Hospital Anxiety and Depression Scale (HADS) before and after the intervention. For data analysis، covariance analysis، paired t-test and independent t-test were performed، using SPSS version 20. The mean age of the participants was 10. 5±2. 4 years in the intervention group and 9. 3±1. 6 years in the control group. Independent t-test showed that anxiety and depression significantly decreased in the intervention group (6. 7±2. 1 and 8. 1±1. 2، respectively)، compared to the control group (10±3. 1 and 10. 2±2. 8، respectively) after the intervention (P<0. 04). Structured cognitive-behavioral group play therapy could be effective in reducing anxiety and depression in children with cancer.

Fatigue is associated with postpartum period، predicting postpartum depression and reduced self-efficacy. However، few experimental studies were conducted on postpartum fatigue and the necessary actions to reduce it. This study aims to investigate the effectiveness of foot reflexology on maternal post C-section fatigue. In this non-randomized clinical trial، 99 mothers having cesarean section، reffering to Valiasr. and Gynecologic Hospitals of Tehran were divided into three groups of 33 in 2012 Foot reflexology and leg massage were performed on patients in the intervention (40 minutes) and placebo groups، respectively. The patients in the control group received the common post C-section care. Visual analogue scale to evaluate fatigue severity was filled out before and three days after the intervention. The data were analyzed performing one-way ANOVA، Chi-Square، Repeated Measures ANOVA and Bonferroni tests، using SPSS version 14. The three groups did not demonstrate any significant differences regarding demographic information and the mean scores of fatigue severity. However، after the interventions، the mean scores of fatigue severity in the experimental and placebo groups were significantly lower than the control group (P<0/001). The comparative analysis of mean fatigue scores، between the experimental (23/2±23/4) and placebo groups (11/7±13/1)، indicated that the reflexology intervention was more effective in reducing fatigue. Sincereduced fatigue was observed in the placebo group، further studies on foot reflexology are required.

Stigma is the most chal­lenging care responsibility in families of individuals with psychological disorders. Considering the evident impacts of cultural and social circumstances on stigma، less attention has been paid to this issue and the conducted interventions are limited. todetermine the effects of psychoeducation on stigma in family caregivers of patients with schizophrenia. In this randomized controlled trial، 60 family caregivers of patients with schizophrenia، hospitalized at Ibn Sina Hospital of Mashhad in 2014-2015، were assigned to intervention (n=30) and control (n=30) groups. The experimental group received psychoeducation according to the model by Falloon et al. (1985) during two 4-hour sessions، while the control group received usual care. The Modified Version of the Internalized Stigma of Mental Illness scale was completed immediately before and one month after the intervention. For data analysis، Fisher’s exact test، Mann-Whitney، independent t-test and paired t-test were performed، using SPSS version 11. 5. In total، 71. 7% of family caregivers were female and 28. 3% were male. Before the intervention، there was no significant difference between the intervention (44. 3±9. 2) and control (43. 8±9. 7) groups regarding the mean score of stigma (P=0. 84). However، the mean change in the total stigma score before and after the intervention was significantly different between the intervention (5. 0±8. 1) and control (0. 03±5. 8) groups (P=0. 01). Considering the influence of psychoeducation on individual aspects of stigma، this method can be applied to reduce stigma at psychiatric hospitals.

Toddlers with celiac disease are at risk of developmental delay due to frequent hospitalization and food deprivation. But an appropriate program to improve development of these children does not exist.

Determination of the effect of a developmental stimulation program on development of toddlers’ fine motor skills.

This clinical trial conducted on 50 eligible 1-3 year-olds، who were randomly divided into intervention and control groups (n=25 each). The intervention group received development stimulation based on developmental age، and the toddlers’ position on the map was designed based on West Virginia guideline. The intervention group received three sessions of stimulation each week for two hours (20 minutes direct and 90 minutes indirect stimulation). Bayley Scale of Infant and Toddler Development was completed immediately after the intervention. The gathered data were analyzed performing independent t-test، Mann-Whitney and repeated measures ANOVA tests، using SPSS.

The mean age of the intervention and control groups were 20. 4±4. 6 and 20. 9±4. 2 months (P=0. 69). Before the intervention، the mean age of fine motor development in the intervention and control groups were 18. 2±5. 7 and 19. 7±6. 1، respectively (P=0. 433). Two months after the intervention، the mean age of fine motor development in the intervention group (24. 6±5. 7) was significantly higher than the control group (20. 8±6) (P<0. 041).

Developmental stimulation program can promote fine motor skills of toddlers at risk of developmental delay with celiac disease.

Intraventricular hemorrhages and respiratory distress syndrome are two common diseases in preterm infants. Observation-based care، may reduce the rate of these complications through energy saving، diminishing apnea periods and cerebral blood flow changes.

to evaluate the effect of behavior observation-based care training for mothers on intraventricular hemorrhages and ventilation period.

In this two-group clinical trial، 70 infants with gestation age of less than 32 weeks were observed in neonate intensive care unit of Omolbanin Hospital، 2014. In the intervention group، the mothers and nurses received training in infant behavior and care program، and preterm infants’ behavior were observed and recorded by means of Assessment of Preterm Infants’ Behavior. At the end of the intervention، incidence of cerebral hemorrhage and the hours of ventilation were recorded. The data were analyzed performing independent t-test، Chi-square and Pearson correlation coefficient، using SPSS.

The mean gestational age for the intervention and control groups were 29. 7±1. 7 and 29. 6±1. 7 weeks، respectively. The incidence of cerebral hemorrhage was 54. 3% (19 cases) for the control group and 22. 9% (8 cases) for the intervention group. The Chi-square test showed a significant relationship between the two groups (P=0. 01). The mean ventilation period was 28. 8±14. 7 days for the intervention group and 17. 3±8. 6 for the control group. The results of independent t-test demonstrated a significant relationship between the two groups (P<0. 001).

The implementation of care training programs for mothers، based on behavior of premature infants، lowers the incidence of cerebral hemorrhage and ventilation period. Conducting this program is recommended to reduce prematurity complications.