Evidence Based Care
Volume:2 Issue: 2, 2012

In the health centers, clinical data is regularly transferred between health care personnel. The most widespread of these handoffs are the inter-shift nursing reports, which occur several times in a day and could facilitate patient care plan, patient safety and continuity of care. But previous studies and clinical experience have indicated that there is no program for this major purpose.

This study was accomplished to investigate the effect of nursing handover written guideline implementation on the performance of respiratory and cardiac nursing care of hospitalized ICU patients.

This was a quasi-experimental one group pretest/post study on 56 nurses working in Intensive Care Unit in Qhaem Hospital who were conveniently selected. The safety performance level of nursing care were evaluated before and after implementation of written guideline using self-structured checklist of performance evaluation of nursing care. Validity and reliability of this instrument was determined by Content Validity Index and Inter Rater Reliability (r=0.95). Data were analyzed using statistical tests including paired t test, Wilcoxon and one-way Anova with SPSS version 11.5.

The results showed that cardiac nursing care performance increased from 1.5±0.6 before intervention to 2.7±0.9 after intervention and in the domain of respiratory care from 9.3±1.9 to 14.5±1.7 which was accompanied with 80% and 55.9% increase, respectively. This difference was significant in cardiac domain based on Wilcoxon test and in respiratory domain using paired t-test (p<0/001).

Development of a regulated, practical and comprehensive standard protocol to transmit crucial and relevant information related to the patient care will improve the nurses performance of respiratory-cardiac nursing care.

Delay in healing- and increasing use of narcotics and anesthetics are some of the accompanying problems with anxiety before the surgery. Massage Aromatherapy and massage are two of the complementary medicine components to decrease anxiety. to compare the effects of massage aromatherapy and massage on anxiety level of the patients in the preoperative period. In this clinical trial, 72 candidates for heart and abdominal surgery who admitted in Ahvaz hospitals in 2008 were randomly allocated into two massage aromatherapy and massage groups. The Spielberger scale was used to measure the anxiety level. Massage aromatherapy group received twenty minutes of stroking backrub with mix of lavandula and almond oils. Massage group received the backrub only with almond oil. The collected data were analyzed by independent t-testusing SPSS version 13 considering P<0.05. The average of anxiety level in massage aromatherapy group decreased from 52.89 +9.20to 35.78+9.26 and in the massage from 50.58+9.47 to 39.25+10.42 before to after the intervention. The results of paired t-test showed significant statistical difference between pre and post intervention in each group (p<0/001).The results of independent t-test showed no significant statistical difference between the two groups after the intervention. The findings showed that massage aromatherapy and massage were equal effecting on reduction of anxiety level and they are proposed for reduction of anxiety in preoperative period as a significant clinical intervention.

Chronic low back pain due to disc herniation is one of the common diseases in the community. In addition to the pain caused by this problem, which is a major complication, decreased and defective physical performance in daily living are other major concerns. To investigate the effect of combined therapeutic protocol (therapeutic exercises and massage) on the pain and physical performance in the patients with chronic low back pain due to the lumbar disc herniation. We conducted a quasi experimental study in two experimental and control groups, each composed of 15 male patients with chronic low back pain. Experimental group were undergone the combined protocol for eight weeks. Control group received no therapeutic protocol during the study period. Subjects’ physical performance was assessed through measuring the duration of five tests which have been modeled based on patients’ daily activities. Visual Analog Scale (VAS) was used to measure pain score. Wilcoxon and t student tests were used for data analysis. The mean score of age, weight, height and Body Mass Index of the subjects were 41.61±4.99 years, 78.55±11.3 kg, 175.81±5.98 cm and 25.36±2.97 kg/m2, respectively. The experimental group showed a significant difference in terms of physical performance (31/41 ± 3/14, p=0/002) and pain score (2/85 ± 1/83, p=0/003). Based on the results, combined therapeutic protocol can be used to improve physical performance and to reduce pain in patients suffering from chronic low back pain due to disc herniation.

Depression and anxiety are highly prevalent in heart failure patients and has been associated with adverse prognosis, reduced functional ability and greater use of health care resources. To determine the effect of using partnership care model on anxiety and depression in heart failure patients. This clinical trial was conducted as quasi-experimental design on 90 patients with heart failure in two educational hospitals in Kerman/Iran in 2010 – 2011. The patients were divided equally and randomly allocated to experimental and control groups. The partnership care model which consisted of 4 main steps of orientation, sensitization, performing and evaluation was performed for experimental group. The level of anxiety and depression of both groups were measured using Beck Depression Inventory and Beck Anxiety Inventory. Data were analyzed by SPSS software (Version 18) using paired t test, one way ANONA, and Chi-square test. The mean score of anxiety in control and experimental groups was 32.73±10.23 and 33.45±11.83 before the intervention, respectively. The scores after the intervention were 35.32±10.10 (in control group) and 13.96±5.05 (in experimental group) (P=0.000). The mean score of depression before running the intervention was 24.73±8.21 in the control group and 26.97±10.40 in the experimental group, which reduced after the intervention to 29.14±8.62 in control group and 13.26±4.25 in experimental group (P=0.000). Applying partnership care model can reduce level of anxiety and depression in heart failure patients. Therefore, it is recommended to use this model to control and reduce anxiety and depression in heart failure patients

Infants who hospitalized in Neonatal Intensive Care Unit are routinely undergoing painful procedures which perhaps has negative impacts on their CNS. Facilitated Tucking is one of the methods of pain relief for these neonates.

To examine the effect of Facilitated Tucking during Venipuncture on pain and physiological parameters in premature infants.

In this experimental study, 70 preterm infants born at average 32-36 week's gestational age (GA), who needed routine blood collection, were allocated to two intervention (35 neonates) and control (35 neonates) groups. during a. In experimental group a nurse held the infant in the side-lying, flexed fetal-type position during blood collection. The infant's pain, HR and Spo2 were measured two minutes before, during and three minutes after the blood collection and their maximum level was recorded. Facial behaviors of pain were recorded independently through video recording. The control group did not receive any intervention for pain relief.

The mean age of newborns were 34/45 ± 1/22 weeks. The results showed that the intervention group had less pain during blood collection than the control group (P = 0.017). But there was no significant difference between two groups in terms of pain score after blood collection. The mean changes in HR and SPo2 were significantly different between two groups (p = 0.001), i.e. were lower in the intervention group

The Facilitated Tucking could cause significant differences in fetal heart rate and arterial blood saturation and intensity of pain copared with the control group, Then it could be used as a procedure to reduce pain during Venipuncture.

The index of weight for age, height for age and weight for height reduces in 6th -18th months of birth. Infancy is the most of period for primary prevention, supporting and teaching of mothers. To determine the effect of supporting complementary feeding program to mothers on 6-12 months infant's anthropometric indexes referring to Mashhad Daneshamooz Health Center from April to July 2011. This was a quasi- experimental study on 72 infants of 6-12months old who were randomly allocated to two groups of experimental (36) and control (36) groups. To collect data demographic questionnaires were completed for parents and infants. Also infant's anthropometric indexes were measured. Supportive Program of Complementary Feeding applied for 3.5 months for experimental group. Control group received routine plan of the health center. The infantile anthropometric indicators were measured based on Z score before and after the intervention in experimental and control groups. Data were analyzed using Chi square and t tests using SPSS 16. The mean weight to age, weight to height based on and BMI to age score for experimental group (0.90, 0.57) compared to control group (0.41, 0.05) (P<0.03). Independent t-test showed significant difference between Z score in experimental and control groups (P=0.03). But there was no significant difference between height to age index in experimental and control group (P=0.45). Supportive Program of Complementary Feeding was an effective approach in increasing infantile anthropometric indicators and may improve physical health. It is therefore suggested to be applied in the hospitals, healthcare centers and nurseries.

The initial review of the holistic nursing theories showed that while most definitions of holism share the same attributes, its application to nursing practice has led to much discourse. This review therefore was carried out to analyze the concept of nursing in three known holistic theories including Rogers, Watson, and Margaret Newman. This concept analysis of nursing in the holistic theories was conducted based on Broom methodology of integrative review. Different stages of review included problem identification, literature search, data evaluation, data analysis, conclusion drawing and verification. The literature was consisted of four books from three known theorists, and eight relevant articles. They retrieved from English data bases including SCOPUS and MEDLINE. The results of nursing concept analysis in holistic theories showed that holistic nursing is a process of mutual relationship of human to human in which the nurse participates in a heart-centered, purposeful and conscious presence, caring of the client as an irreducible, respectful whole, in mutual relation with environment. This requires individual empowerment and intentionality of the nurse as well as client’s trust. to the consequence of this relationship is a feeling of well being for both partners and protection, enhancement, and preservation of human dignity. Through the process of concept analysis in this study we conclude that holistic nursing is a mutual evolving participative process. Although the basis of these holistic theorists’ thoughts of holism is similar, but each theorist has viewed a special aspect of its application. The analysis of nursing concept gives us a theoretical integrative definition consists of the attributes and the requirements of its application and the exact role of each partners in the caring relationship process that can help to clarify, measure and use this concept in clinical practice.

Happiness is accounted for one of the psychological health criteria, and is considered as one of the six fundamental emotions- in human beings. Labor pain is also considered as one of the exclusive experiences, which demands pregnant women’s ability to cope with it. Happiness may give this potential ability to the pregnant women to apply skillful coping methods to tolerate the labor pain, but there is no registered evidence about this relationship. To determine the relationship between happiness during pregnancy and labor pain coping behaviors. In this correlational study 80 low risk pregnant women, in the 36 – 40 weeks of pregnancy, who have referred to Omolbanin Hospital for prenatal care were selected using convenience sampling. Demographic information and the level of happiness were measured during pregnancy using Oxford Happiness Questionnaire. Labor pain coping behaviors were measured during contractions, and each half an hour from the dilatation of 3–5 cm till delivery using Labor Pain Coping Behaviors Observation Form. Data were analyzed with SPSS version 16 using Kruskal-Wallis, One- way ANOVA, Mann-Whitney tests and Spearman and Pearson correlation coefficients. The frequency of low, medium and high level of happiness was 11.3%, 72.5%, and 16.2% respectively. Also, 16.3% of the pregnant women showed unfavorable, 50% acceptable, and 33.7% favorable labor pain coping behaviors. The results of Spearman’s correlation test revealed that there was a significant relationship between pregnancy happiness and the mean score of labor pain coping behaviors, (p = 0.000, and r = 0.444), i.e. higher levels of happiness during pregnancyis associated with more favorable labor pain coping behaviors. The parturient's behavior during labor indicates her level of emotion. So in parturient’s clinical management, in addition to physiological signs and clinical examinations these two issues should be considered as well.