Evidence Based Care
Volume:9 Issue: 4, Winter 2020

Control and maintenance of endotracheal tube cuff pressure and prevention of sore throat are major concerns in post-anesthesia care.

This study aimed to evaluate changes in the pressure of the endotracheal tube cuff filled with saline versus air and post-anesthesia sore throat when the position is altered from supine to lateral.

Thisdouble-blind randomized clinical trial was performed on 60 participants under lateral hip replacement surgery in an educational, research, and treatment center in the northeast of Iran in 2018-2019. After intubation, the cuffs of the intervention and control groups were filled with saline and air, respectively. Cuff pressures and Visual Analog Scale of sore throat were measured and analyzed using repeated measures ANOVA and Pearson's correlation coefficient in SPSS software, version 20.

The mean ages of the participants in the intervention and control groups were 45.8±11.6 and 40±13.1 years, respectively. Changes in the cuff pressure of different time points were statistically significant in both intervention (P=0.03) and control (P=0.02) groups. Based on the results of the independent sample t-test, the pain score was significantly different between the intervention (0.1±0.4) and control (1.1±2.1) groups 12 h post-surgery (P=0.01). The results of the Pearson’s correlation coefficient revealed a significant association between the pain score 12 h post-surgery and pressure difference of the fifth and first stages in the control group (r=0.585, P=0.001). In addition, the 12-h pain score and the pressure difference of the fifth and fourth stages were also significantly correlated in the control group )r=0.479, P=0.01).

Based on the findings, in the lateral-position hip surgery, the use of saline to fill the endotracheal tube cuff could lead to better control of cuff pressure and may also reduce the postoperative sore throat.

Hospitalization is recognized as a frightening and stressful experience for children. These negative consequences are intensified when children experience a frequent number of hospitalizations. In this regard, various non-pharmacological approaches have been introduced to reduce these negative consequences, one of which is playing and listening to music.

The present study aimed to determine the effect of music therapy and distraction cards on the anxiety of hospitalized children with chronic diseases.

This randomized clinical trial was performed on 83 children with chronic diseases aged 8-12 years who were hospitalized in Akbar Pediatric Hospital in Mashhad, Iran. The participants were assigned to three groups, namely cards, music, and cards + music groups. The intervention which involved listening to favorite music and playing with distraction cards was performed on two consecutive days (duration=20 minutes). Data collection tools included the Spence Children’s Anxiety Scale and demographic characteristics questionnaire. Data were analyzed in SPSS software (version 22) using descriptive and inferential statistics.

In the current study, the mean scores of children’s anxiety in the groups of music, cards, and cards + music after the intervention were reported as 54.8±20.1, 42.7±15.0, and 51.3±15.5, respectively. Moreover, the ANOVA results demonstrated a significant difference in this regard (P=0.038).In addition, the Wilcoxon test results were indicative of a significant difference between the cards (P=0.013) and cards + music (P=0.015) groups regarding the three subscales of anxiety before and after the intervention.

Playing with distraction cards decreased anxiety and fear in children to a greater extent, as compared to music therapy. Therefore, the active distraction method can be a practical approach to reduce anxiety and fear in hospitalized children.

Among different factors, self-efficacy is one of the most suitable components for predicting smoking behavior among adolescents. Therefore, it is essential to design a native tool to measure this high-risk behavior in adolescents and implement prevention programs in this age group.

This study aimed to design and validate a smoking abstinence self-efficacy questionnaire in female adolescents.

In this methodological study, a comprehensive literature review was conducted, and the available similar questionnaires were used to prepare the items. In total, 351 female schoolchildren were selected by convenience sampling in Mashhad, Iran, between October 2017 and January 2018. Face and content validity and construct validity were applied for psychometric evaluation of the developed tool. The reliability of the tool was tested by internal consistency.

The final version of the smoking abstinence self-efficacy scale in Iranian female adolescents includes 16 items after a psychometric evaluation. The content validity of the tool was obtained at 0.99. Moreover, exploratory factor analysis explored three factors of emotional, social, and high-risk situations explaining 60% of the variance. Cronbach's alpha coefficient of the questionnaire was estimated at 0.94.

The smoking abstinence self-efficacy scale is a valid and reliable tool among Iranian female adolescents derived from the native context of this group of people which can examine smoking abstinence self-efficacy in three dimensions of emotional, social, and high-risk situations. Moreover, it can identify adolescents with different levels of smoking abstinence self-efficacy.

Multiple Sclerosis (MS) is a common disease among youngsters and self-efficacy is a crucial factor in these patients. Various variables, including demographic characteristics and disease symptoms, affect self-efficacy. Therefore, it is necessary to assess the relationship between these factors using a clear and comprehensive model.

this study aimed to investigate the self-efficacy model for MS patients.

This descriptive-correlational study was performed on 203 patients referring to the Iran MS Society. Data collection tools entailed Rigby Multiple Sclerosis Self-efficacy Scale, Krupp Fatigue Severity Scale, and Rosenberg Self-Esteem Scale. Data were analyzed by the SPSS 24 and LISREL 8.8.

The mean scores of self-efficacy, fatigue, and self-esteem were found as 39.6±9.1, 38.1±14.4, and 19±7.6, respectively. The model fit indices, including the goodness of fit index, comparative fit index, root mean square error of approximation, normalized fitness index, non-normalized fitness index, and the degree of freedom for the Chi-square were obtained as 0.9, 1, 0.002, 0.9, 0.9, and 1.03, respectively. Results indicated an appropriate prediction for the paths considered to determine the relationship between variables. Our findings demonstrated a significant correlation between self-efficacy and self-esteem (r=0.2), fatigue and self-esteem (r=-0.1) (P<0.001), as well as family support and self-esteem. Moreover, fatigue was observed to have a significant relationship with marital status, hospitalization, and exercise. However, no significant relationship was observed between fatigue and self-efficacy (r=0.02) (P>0.05).

The results showed that the Bandura model of self-efficacy can be used for the demographic and clinical variables of MS patients. Findings of this study can be helpful in developing and implementing instructional plan to improve self-efficacy in these patients.

Parents of children with cancer experience intense anxiety.

This study aimed to evaluate the impact of emotion regulation training based on the Gross model on anxiety among the parents of children with cancer.

This randomized controlled clinical trial was conducted on 60 parents of children with cancer admitted to a 130-bed pediatric hospital in Western Iran in 2018. Anxiety level was assessed pre- and post-intervention using the Beck Anxiety Inventory. The individuals of the test group attended emotion regulation training based on the Gross model, while the participants in the control group received routine training. The data were analyzed by the SPSS software version 23 using the repeated measures analysis of variance (ANOVA) and independent t-test.

Our findings demonstrated that the mean age of participants was 32.5±5.09 and 32.26±4.9 years in the intervention and control groups, respectively. Total anxiety scores of the intervention and control groups pre-intervention were obtained as 33.9±7.1 and 34.3±7.4, respectively. This score changed to 19.2±1.47 in the test group and 33.73±1.36 in the control group immediately post-intervention. Moreover, three months post-intervention, the scores of 22.17±5.8 and 34.03±6.96 were observed in the control and intervention groups, respectively. The repeated measures ANOVA revealed a significant difference between the two groups in terms of the effect of the intervention (P<0.001).

Emotion regulation training based on the Gross model could decrease anxiety levels in the parents of children with cancer. Therefore, it is recommended to be applied by caregivers for this group of people

Patients admitted to the cardiac care unit (CCU) are prone to functional degradation and disability due to prolonged hospitalization and cardiovascular diseases. The aim of this study was to assess the activities of daily living (ADLs) after discharge from CCU. This descriptive cross-sectional study was performed on 180 subjects selected through convenience sampling from the patients admitted to the post-CCU of the hospitals affiliated to the three major medical universities of Tehran, Iran. The ADLs were evaluated by the Barthel index and the data were analyzed by the Wilcoxon test using SPSS version 19. P < 0.05 was considered significant. Bathing had the highest dependence level (21.1%) and disability in this activity increased from 12.8% to 33.9% after discharge. The lowest dependence was found for feeding (2.8%) anddependence augmented after admission, compared to before (92.96±16.02 and 82.85±22.22, respectively). The findings of this study could be applied in empowering the caregivers and designing home care plans for the patients after discharge from the CCU.

Advancements in assisted reproductive technology (ART) has increased the nurses' contribution to the provision of ART services. The present descriptive cross-sectional study aimed to determine essential care skills for nurses working at the selected infertility clinics in Tehran, Iran, based on their perspectives within 2016-2017. A total of 59 nurses were selected via a convenience sampling method and the data were collected using a researcher-made questionnaire. Data analysis was performed using SPSS software (version 21). Furthermore, the results of the Spearman’s rank correlation coefficient highlighted items associated with three domains of knowledge, attitudes, and practices required for nurses from their perspectives (94.9%). Given that nurses have constant contact with clients in infertility clinics and considering the lack of studies on essential care skills for nurses working at such centers, the results of this study would help to define job descriptions and determine the necessary care skills for the nurses.

Youngsters' addiction potential has made adolescence a highly sensitive and critical period of life. Educational interventions can affect addiction prevention and cooperative learning is one of the active education methods. The present study aimed to determine the effect of cooperative learning on drug addiction potential among female students. This randomized controlled clinical trial was performed on 66 female students in 2018. The intervention group attended four cooperative educational sessions on addiction, physical, psychological, social and economic consequences and complications of drug abuse, and effective communication skills. On the other hand, the participants in the control group received education in the form of lectures. The addiction potential questionnaire was filled by all subjects before and one month after the intervention. Data were analyzed in SPSS software (version 16) using an independent t-test, paired t-test, and Wilcoxon test. According to the results, the two groups were homogenous in terms of all demographic variables. As evidenced by the results of the independent t-test, the mean score of addiction potential was significantly lower in the intervention group (10.3±12.4), compared to the control group (2.7±8.8) (P<0.001). Our findings can help instructors select and implement the most efficient techniques of cooperative learning in order to prevent addiction among adolescents.