Chronic fatigue syndrome post-COVID-19: triple-blind randomised clinical trial of Astragalus root extract.

OBJECTIVE: This study aimed to evaluate the effect of Astragalus root extract on nurses suffering from post-COVID-19 chronic fatigue syndrome. MATERIALS AND METHODS: The study was designed as a triple-blind, randomised, controlled trial in Iran in 2023. 64 chronic fatigue syndrome nurses were randomly assigned to one of two groups: an intervention group (n=32) that received Astragalus root extract (500 mg two times per day) or a control group (n=32) that received a placebo. Changes in chronic fatigue syndrome scores were measured before to, at the end of and 1 month after the intervention. Data were analysed using descriptive and analytical statistics (T-tests, χ2, analysis of variances, Cochran's Q tests, McNemar and generalised estimating equations). RESULTS: In comparison to before, chronic fatigue prevalence decreased statistically significantly at the end of the intervention group (13.8%) and 1 month later (17.2%). Further, the frequency differed between before and after (p=0.0001) and 1 month later (p=0.0001). In the control group, chronic fatigue was statistically significantly different before and after the intervention (72.2%; p=0.003). Having an underlying disease (B=0.84, OR=2.33; p=0.04) and being in the control group (B=2.15, OR=12.36; p=0.01) increased the risk of chronic fatigue, whereas increasing the length of time decreased it (B=-0.67, OR=0.50; p=0.0001). CONCLUSION: Astragalus root extract has been shown to reduce chronic fatigue in nurses. Therefore, this herbal extract can be used to reduce the incidence and treatment of chronic fatigue in nurses.

Nurses' motivation for performing cardiopulmonary resuscitation: a cross-sectional study.

BACKGROUND: Nurse motivation can have a significant impact on the quality of cardiopulmonary resuscitation and the patients' survival. Therefore, the present study aimed to examine nurses' motivation for performing cardiopulmonary resuscitation. METHODS: This cross-sectional study focused on 217 nurses in a teaching hospital in Iran, in 2023. A random sample of nurses was selected from four hospital departments (emergency, critical care, medical, and surgery). These nurses completed the demographic information and motivation for cardiopulmonary resuscitation questionnaires. The data were analyzed using Mann-Whitney, Spearman coefficients, and Kruskal-Wallis and multiple linear regression tests. RESULTS: The mean score of the dimension of the feeling of achievement (4.10 ± 0.50) was high in the nurses' motivation for performing cardiopulmonary resuscitation. There were more motivational factors in the emergency department compared to the other departments in terms of the feeling of achievement, high chance of success, low chances of success, recognition and appreciation, perceived importance, and beliefs (p < 0.05). The nurses who had participated in cardiopulmonary resuscitation workshops and had a bachelor's degree had a higher mean score in the dimension of perceived importance (p < 0.05). The correlation coefficient showed that there was a significant negative correlation between the nurses' frequency of participation in cardiopulmonary resuscitation and their motivation scores in the dimensions of the feeling of achievement(r=-0.170), low chances of success(r=-0.183), perceived importance (r = -0.302), and beliefs (r = -0.250; p < 0.05). The department variable predicted the motivation score in the dimensions of feeling of achievement, high chance of success, low chance of success, perceived importance, and beliefs. The sex variable predicted the motivation score in the dimensions of facilitator of resuscitation and high chance of success. Besides, the variable of years of membership in the CPR team predicted the motivation score in the feeling of achievement and high chance of success (p < 0.05). CONCLUSION: Nurses would be more motivated to perform a quality cardiopulmonary resuscitation if they had a feeling of success. The nurses' motivation was affected by certain factors such as their department, sex, education level, years of membership in CPR team, number of participation in CPR, and participation in educational workshops.

Development and psychometric testing of the Aesthetics of Everyday Life Scale in Aging (AELSA).

BACKGROUND: The aesthetics of everyday life improves physical and mental health and social communication. This study aims to develop and test a novel instrument that assesses the aesthetics of the everyday life of older adults. METHODS: A mixed-methods study with a sequential exploratory approach was conducted from November 2021 to December 2022. Item generation and questionnaire formation were developed through interviews with older adults and a literature review (stage 1). A cross-sectional study was then conducted to test the psychometric properties of the novel scale among 380 older adults referred to Urban Comprehensive Health Service Centers (stage 2). The construct validity was tested via exploratory factor analysis (EFA) and with the principal component analysis method. Internal consistency and reliability of the scale were evaluated with Cronbach's alpha and test-retest with a 2-week interval. RESULTS: The initial scale was prepared with 39 items. In stage 2, EFA revealed a seven-factor model with 34 items. Internal consistency was acceptable for extracted sub-scales (Cronbach's alpha range: 0.67- 0.93) and the total score (0.926). The intra-class correlation coefficient for test-retest reliability was 0.90. CONCLUSIONS: The AELSA is a valid and reliable instrument for evaluating the aesthetics of everyday life in older adults. the scale will help policymakers in formulating interventions to improve mental health and well-being in older adults. Moreover, Further studies is need to provide more support of construct validity.

Pain and sleep after open-heart surgery-inhalation peppermint essence: double-blind randomized clinical trial.

OBJECTIVE: The aim of this study was to determine the effect of inhaling peppermint essence on pain relief and sleep quality after open-heart surgery. METHODS: In a double-blind randomised clinical trial carried out in Iran in 2020, 64 cardiac patients were selected by convenience sampling and randomly allocated to aromatherapy (n=32) and placebo (n=32) groups. The aromatherapy and control groups received inhaled aromatherapy using peppermint essence and distilled water, respectively. Data gathering tools were the Numeric Pain Rating Scale and St Mary's Hospital Sleep Questionnaire. Data were analysed using an independent t-test, χ2 test, Mann-Whitney U test and generalised estimating equation analysis. RESULTS: The mean severity of pain in the aromatherapy and placebo groups was 3.22±0.88 and 4.56±0.90, respectively, which was a statistically significant difference (p=0.0001). The mean sleep scores after the intervention on day 1 were 20.10±4.90 and 25.76±6.36 in the aromatherapy and placebo groups, respectively, and 18.63±5.56 and 22.62±5.69, respectively, on day 2. The difference between the two groups was statistically significantly different after the intervention in terms of sleep quality (p<0.05). CONCLUSION: Aromatherapy attenuated pain and improved sleep quality after open-heart surgery. Peppermint essence aromatherapy is therefore recommended after surgery.

Aesthetics of everyday life and its related factors among older adults in Kashan (2021-2022).

BACKGROUND: Aesthetics of everyday life are associated with the physical, mental, and social health of older adults, leading them to experience a successful old age. This study aimed to examine the aesthetics of everyday life and its related factors among older adults in Kashan from 2021 to 2022. METHODS: This cross-sectional study consisted of 350 older adults who were referred to Urban Comprehensive Health Service Centers (UCHSC) in Kashan. Sampling was done by a two-stage method (cluster, random). The data collection was performed with a background information questionnaire and the Elderly's Perception of Everyday Aesthetics scale (EPEA-S). Data were analyzed using an independent t-test, analysis of variance, Pearson's correlation coefficient, and multiple linear regression tests in the SPSS software. RESULTS: The mean age of the participants was 69.56 ± 6.63 years. The mean score of aesthetics of everyday life in older adults was 133.02 ± 14.73, with the family and others subscale receiving the highest score. The univariate test indicated a statistically significant correlation between age, employment status, education, income, smoking, social activities, physical activities, interest in artistic works, and the aesthetics of everyday life in older adults (P < 0.01). Multivariate linear analysis showed that age, employment status, smoking, income, social activities, physical activities, and interest in artistic works predicted and explained 28% of the variance of life aesthetics in older adults (R2 = 0.28). CONCLUSIONS: The aesthetics of everyday life of the Iranian older adults were in a good range. Healthcare providers and families of older adults can use this concept to enhance the elderly's physical, mental, and social health.

The effect of rewarming on hemodynamic parameters and arterial blood gases of patients after open-heart surgery: A randomized controlled trial.

INTRODUCTION: Hypothermia after open-heart surgery can have potential side effects for patients. AIM: This study aimed to examine the effects of rewarming on patients' hemodynamic and arterial blood gases parameters after open-heart surgery. METHODS: This randomized controlled trial was performed in 2019 on 80 patients undergoing open-heart surgery at Tehran Heart Center, Iran. The subjects were consecutively recruited and randomly assigned to an intervention group (n=40) and a control group (n=40). After the surgery, the intervention group was warmed with an electric warming mattress while the control group warmed using a simple hospital blanket. The hemodynamic parameters of the two groups were measured 6 times and arterial blood gas was measured 3 times. Data were analyzed by independent samples t and Chi-squared tests, and repeated measures analysis. RESULTS: Before the intervention, the two groups did not significantly differ in terms of hemodynamic and blood gas parameters. However, the two groups were significantly different in the mean heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, temperature, right and left lung drainage in the first half-hour, and the first to fourth hours after the intervention (p < 0.05). Furthermore, there was a significant difference between the mean arterial oxygen pressure of the two groups during and after rewarming (P <0.05). CONCLUSION: Rewarming of patients after open-heart surgery can significantly affect hemodynamic and arterial blood gas parameters. Therefore, rewarming methods can be used safely to improve the patients' hemodynamic parameters after open-heart surgery.

Effect of an early mobilisation programme on pain intensity after laparoscopic surgery: a randomised clinical trial.

BACKGROUND: Pain is a common complication after laparoscopic surgery. This study aimed to examine the effect of an early mobilisation programme on postoperative pain intensity after laparoscopic surgery. METHODS: A randomised controlled clinical trial was conducted on 80 patients who underwent laparoscopic surgery in Shahid Beheshti Hospital in Kashan, Iran. The patients were randomly allocated to intervention (n=40) and a control (n=40) group. In the intervention group, an early mobilisation programme was implemented in two rounds. The patient's perceived pain was assessed using a Visual Analogue Scale 15 min before and 30 min after each round of early mobilisation. Data were analysed through the independent samples t, χ2 and Fisher's exact tests and the repeated measures analysis. RESULTS: The repeated measures analysis showed that the mean pain scores have been decreased over time (F=98.88, p<0.001). Considering the observed interaction between time and the intervention, the t test was used for pairwise comparisons and showed that the mean pain score was not significantly different between the two groups in 15 min before the first round of early mobilisation (p=0.95). However, the mean pain in the intervention group was significantly less than the control group in all subsequent measurements (p<0.05). CONCLUSION: Early mobilisation programmes such as the one implemented in the current study are easy and inexpensive and can be implemented safely for the reduction of pain after laparoscopic surgeries.

Comparison of the Effect of Forced-air Warming and Warmed Intravenous Fluid on the Comfort and Prevention of Shivering After Spinal Anesthesia in Patients Undergoing Orthopedic Surgery.

PURPOSE: This study aimed to compare the effect of forced-air warming and warmed intravenous fluid on the comfort and prevention of shivering after spinal anesthesia in patients undergoing orthopaedic surgery. DESIGN: Randomized controlled clinical trial. METHODS: A total of 120 patients were randomly divided into three groups: forced-air warming (38°C), warmed intravenous fluid (37°C), and the control group. Patients' comfort and severity of shivering were measured and recorded five times (immediately and 15 minutes after spinal anesthesia, end of the surgery, time of entrance to the recovery room, and 15 minutes after entering the recovery room), and compared with each other. FINDINGS: There was a significant difference between the three groups in terms of comfort at all points of evaluation times (P < .001). The comfort score in the control group was significantly higher than the two intervention groups (P < .001). Moreover, the comfort score in the warmed intravenous fluid group was significantly higher than the forced-air warming group (P < .001). In addition, there was a significant difference in shivering severity between the three groups at the end of the surgery, entrance to the recovery room, and 15 minutes after surgery (P < .001). The majority of patients in the forced-air warming group (90%) had no shivering at all three times, while the warmed IV fluid and control groups was 65% and 30% respectively. CONCLUSIONS: Non-pharmacological methods such as forced-air warming and warmed intravenous fluid can provide comfort and prevent shivering in orthopaedic patients undergoing spinal anesthesia. However, the use of forced-air warming is more effective than warmed intravenous fluid in providing comfort and preventing shivering in these patients. It is recommended that these methods be used in the operating room to provide comfort and prevent shivering in these patients.

The effect of aromatherapy with peppermint essential oil on nausea and vomiting after cardiac surgery: A randomized clinical trial.

Background Postoperative nausea and vomiting are common in patients who underwent cardiac surgery. This study aimed to examine the effect of peppermint essential oil inhalation on the postoperative nausea and vomiting after cardiac surgery. Methods In this clinical trial study, 60 cardiac surgery patients were divided into control and intervention groups. The intervention group underwent nebulizer aromatherapy with peppermint essential oil before the endotracheal tube was removed after surgery. Patients' nausea and vomiting were then assessed through a checklist. The independent-samples t-test, chi-square, and Generalized estimating equation were used for data analysis. Results Totally 85.7% of the patients undergone coronary artery bypass graft surgery. The two groups did not significantly differ in terms of their baseline demographic and clinical variables (P > 0.05). Significant differences were found between the intervention and control groups in terms of the frequency of nausea (0.63 ± 0.81 vs. 1.46 ± 1.21), its duration (3.78 ± 5.09 vs. 7.97 ± 5.55 min), and severity (2.43 ± 2.84 vs. 4.61 ± 2.85), and in the frequency of vomiting episodes (0.17 ±.46 vs. 0.73 ±.60) in the first four hours after extubation (P < 0.05). Conclusion: Peppermint essential oil inhalation has beneficial effects on reducing nausea and vomiting after open-heart surgery. Using peppermint essential oil inhalation for managing postoperative nausea and vomiting is recommended.

Body image before and after coronary artery bypass graft surgery: comparison and its contributing factors.

BACKGROUND: Cardiovascular diseases are the leading cause of death in the world. Coronary artery bypass graft (CABG) surgery is among the treatment options for coronary artery disease. However, it is associated with significant physical and psychological problems. This study sought to compare body image before and after the surgery and to determine its contributing factors. METHODS: This comparative study was conducted in 2017 on a sample of 140 patients consecutively recruited from Shahid Beheshti hospital, Kashan, Iran. Body image was assessed before and 4 weeks after the surgery (T1 and T2) using Multidimensional Body-Self Relations Questionnaire. The independent-sample and paired t tests, one-way analysis of variance, Pearson correlation test, and multiple regression were conducted for data analysis. RESULTS: Participants' mean score of body image was 139.60 ± 13.21 at T1 and 160.25 ± 7.75 at T2 and the variation was statistically significant (p = < 0.001). At T1, only the three factors of age (p = 0.005), education at high school diploma and higher levels (p < 0.001), and being housekeeper (P = 0.048) could significantly explain BI (R2 = 0.231). However, at T2, none of the factors were significant predictors for BI (P > 0.05). CONCLUSIONS: Candidates for CABG have poor body image. After the surgery, their body image improves significantly. Healthcare providers need to employ programs to improve body image among these patients.

Critical thinking skills in nursing students: a comparison between freshmen and senior students.

BACKGROUND: Critical thinking is one of the most important concepts in the field of education. Despite studies published on nursing students' critical thinking skills (CTS), some suggest that there is not enough evidence supporting the relationship between content of nursing education programs and nursing students' CTS. OBJECTIVES: Given the existing discrepancies, this study aimed to compare the critical thinking skills of freshmen and senior nursing students. PATIENTS AND METHODS: This comparative study was conducted on 150 undergraduate freshmen and senior nursing students in Kashan University of Medical Sciences, during 2012. The students in the first and the last semesters of their study in nursing were entered in the study using the census method. Data were collected using a questionnaire including questions on demographic data and the California Critical Thinking Skills Test, form B. Data analysis was performed using the SPSS v.13 software. Descriptive statistics were calculated. Moreover, independent sample t-test and Spearman and Pearson's correlation coefficients were used in the data analysis. RESULTS: Both the freshmen and senior nursing students had low CTS. The mean critical thinking scores were 11.79 ± 4.80 and 11.21 ± 3.17 for the freshmen and the senior students, respectively (P = 0.511). Moreover, no significant correlation was found between the students' score in CTS and their age, gender, high school grade point average (GPA), rank in university entrance examination (RUEE) and interest in the nursing profession. CONCLUSIONS: The students were low skilled in critical thinking and their CTS did not significantly change during their nursing degree. Thus it may be concluded that the nursing education program did not affect the CTS of its students. Longitudinal studies are suggested for assessing nursing students' critical thinking over time. Moreover, revising the curriculum and preparing nursing educators for implementing innovative and active teaching strategies are suggested.

Quality of working life of nurses and its related factors.

BACKGROUND: Nurses as the largest group of health care providers should enjoy a satisfactory quality of working life to be able to provide quality care to their patients. Therefore, attention should be paid to the nurses' working life. OBJECTIVES: This study aimed to investigate the quality of nurses' working life in Kashans' hospitals during 2012. MATERIALS AND METHODS: This cross-sectional study was conducted on 200 nurses during 2012. The data-gathering instrument consisted of two parts. The first part consisted of questions on demographic information and the second part was the Walton's quality of work life questionnaire. Data were analyzed using the SPSS software. For statistical analysis T test and one way ANOVA were used. RESULTS: The results of the study showed that 60% of nurses reported that they had moderate level of quality of working life while 37.1% and 2% had undesirable and good quality of working life, respectively. Nurses with associate degrees reported a better quality of working life than others. A significant relationship was found between variables such as education level, work experience, and type of hospital with quality of working life score (P < 0.05). No significant differences were observed between quality of working life score of nurses with employment status (P = 0.061), salary (P = 0.052), age, gender and marital status (P > 0.05). CONCLUSIONS: Nurses' quality of work life was at the moderate level. As quality of work life has an important impact on attracting and retaining employees, it is necessary to pay more attention to the nurses' quality of work life and its affecting factors.

Intensive care nurses' opinions and practice for oral care of mechanically ventilated patients.

CONTEXT: Oral care is an essential aspect of critical care nursing. However, no study has been published on oral care practice of Iranian and Asian nurses. The majority of published studies were conducted in western and European countries. AIMS: This study aimed to evaluate the nurses' opinions and practice about oral care in patients under mechanical ventilation. SETTINGS AND DESIGN: A cross-sectional study was conducted on 130 intensive care nurses from 6 intensive care units in the university hospitals of Iran. MATERIALS AND METHODS: A questionnaire was used to gather the data and charts of 45 patients were evaluated. STATISTICAL ANALYSIS: Descriptive statistical analysis are presented. RESULTS: Oral care obtained the 7(th) rank in prority and a mean score of 5.7 on a scale of 1-10. More than 21% of subjects did not perform oral care in their usual duties. High load of writing tasks and personnel shortages were the major barriers to oral care. Only 20% of the patients' charts contained a report on oral care. CONCLUSIONS: Nurses did not consider oral care in intensive care patients as a high priority. This result highlights the need to continue education programs on oral care for improving the knowledge and attitude of intensive care nurses with respect to oral care.