Care burden and the predictive role of spiritual well-being and religious coping: A cross sectional study among Iranian family caregivers of patients with stroke.

Background and Aims: The burden of care after a stroke is gaining recognition as a significant healthcare issue. Factors like religion and spirituality, encompassing religious coping and spiritual health, prove to be influential in anticipating the challenges faced by caregivers. The present study aimed to determine the relationship between care burden, spiritual health, and religious coping among caregivers of stroke patients. Methods: This cross-sectional research was conducted with the participation of 129 caregivers of stroke patients. The data was collected using the Ellison and Paloutzian spiritual well-being instruments, Pargament Religious Coping (RCOPE) brief version, and the Zarit burden interview (ZBI). Through a census, participants were recruited for the investigation. Data were analyzed using descriptive and inferential statistics (multivariate linear regression analysis). Results: The study results indicate a strong and statistically significant relationship between the burden of caring and spiritual health (p < 0.001, ß = 0.33). Furthermore, specific variables were identified as indicators of an increased burden of care, including positive religious coping (p = 0.04, ß = 0.63), the familial relationship between the caregiver and patient, specifically as a child (p = 0.001, ß = 29.26), and a sister (p < 0.001, ß = 35.93). Conclusion: It is advisable to consider adopting and implementing appropriate support measures for coping strategies rooted in religion and spirituality. So, it is recommended to enhance the provision of comprehensive support, including psychological and religious interventions. This can be achieved through the collaborative efforts of support groups comprising psychiatric nurses, psychiatrists, psychologists, and religious experts.

Effect of acupressure in the third eye point (EX-HN 3) on psychological distress, comfort and physiologic parameters among patients undergoing coronary angiography.

AIM: The present study aimed to investigate the effect of acupressure on comfort, anxiety, stress, depression, and vital signs in patients undergoing coronary angiography. METHODS: This randomized clinical trial was conducted on patients who underwent coronary angiography in Tehran, Iran. Seventy patients were randomly assigned to the intervention and control groups. The intervention protocol consisted of 20 min of acupressure applied to the Yintang point, and standard medical care was applied to the control group. Depression, Anxiety, and Stress questionnaire (DASS-21), General Comfort Questionnaire (GCQ) questionnaires, and standard monitoring were used as data collection tools before and after intervention, as well as after angiography. Data were analyzed using an independent sample t-test, chi-squared, and analysis of variance of repeated measures in SPSS software, and the level of significance was set at 0.05. FINDINGS: The results showed that before acupressure, there was no statistically significant difference between the two groups. Anxiety and stress scores and comfort levels decreased significantly after the intervention (p < 0.001), while no significant difference was observed in the depression score (p = 0.873). There was a significant decrease in the blood pressure, breathing rate, and heart rate in the intervention group. CONCLUSION: Acupressure can reduce the anxiety and stress of angiography candidates and make them more comfortable. It also reduces the blood pressure, breathing rate, and heart rate. Further studies at different pressure points and on a larger and more detailed scale are necessary.

Benson relaxation technique to address sleep quality and aggression among patients with bipolar type I disorder: A randomized clinical trial study.

Purpose: The present research was conducted to assess the effect of the Benson relaxation technique on sleep quality and aggression among patients with bipolar type I disorder. Methods: This study was conducted using a randomized clinical trial design with the participation of 60 patients with bipolar type I disorder (30 participants in each group) in Mashhad, Iran (IRCT20220108053659N1). The intervention group received the Benson relaxation technique for 21 days in a row, twice a day (in the morning and evening), under the supervision of an expert psychiatric nurse (On the first day, instruction was given on implementing BRT. In the subsequent days of the intervention, the nurse stayed by the patient's bedside for the entire relaxation process). Aggression and sleep quality were assessed using the Buss-Perry Aggression Questionnaire and Pittsburgh Sleep Quality Index, respectively, before and one week after the completion of the intervention. Data were analyzed using descriptive and inferential statistics (Chi-squared, Fisher's exact test, independent sample t-test, and analysis of covariance). Results: The participants in the present study were individuals of both genders aged 18 and above. Based on the results, both groups were homogeneous regarding demographic characteristics. Prior to the intervention, the two groups of control and intervention were not significantly different from each other in terms of sleep quality (p = 0.870) and aggression (p = 0.961). After the intervention, in an intergroup comparison, a significant difference was observed between the two groups in terms of the mean difference of aggression (p < 0.001) and sleep quality scores (p < 0.001). Conclusion: Despite the favorable effect of this intervention, it is necessary to conduct more studies considering the broader aspects of interventions and related variables before including these interventions in the care plan of patients with bipolar type I disorder.

Psychometric evaluation of the Persian version of the Sense of Belonging in Nursing School (SBNS): a quantitative and cross-sectional design.

BACKGROUND: This study aimed to evaluate the psychometric indicators of the Persian version of the Sense of Belonging in Nursing School scale (SBNS). METHODS: The study conducted in Shahroud and Semnan schools of nursing and midwifery in Iran examined nursing students using a cross-sectional approach by convenience sampling method from 3/6/2023 to 24/8/2023. To assess the SBNS scale, the forward-backward procedure was used to translate it into Persian. Face and content validity were evaluated, and exploratory and confirmatory factor analyses were conducted with sample sizes of 200 and 182, respectively. Reliability was assessed using Cronbach's alpha coefficient, MacDonald's omega, and intra-class correlation coefficient. RESULTS: The exploratory factor analysis resulted in the exclusion of four items, leaving a final selection of 15 items. These items were categorized into three factors: classmates, clinical staff, and inclusive educational environment, which accounted for 49.16% of the overall variance. The confirmatory factor analysis indicated that the model was a good fit for the observed data, and the subscales had high internal consistency (Cronbach's alpha coefficient was 0.752 to 0.880) and stability (intra-class correlation coefficient was 0.889 to 0.968). CONCLUSION: According to the results, it can be concluded that the Persian version of the SBNS scale demonstrates sufficient validity and reliability in assessing students' sense of belonging to the nursing school.

Effectiveness of a supportive care program via a smartphone application on the quality of life and care burden among family caregivers of patients with major depressive disorder: a randomized controlled trial.

BACKGROUND: The majority of patients with major depressive disorder require care that has generally affected caregivers' lives. Providing care could cause negative experiences as a care burden and deteriorate quality of life. However, there is a lack of evidence about caregiver training-based informatics and its impact on the caregiver's life. METHODS: This experimental study was carried out in Mashhad, Iran. A total of 60 primary family caregivers of patients with major depressive disorder were included in the study between February and July 2021. The quadruple block randomization method was used to allocate the participants into control and intervention groups. In the intervention group, family caregivers used the application with weekly phone calls for one month. The app contains the most important points of patient care and has the possibility of communicating with the nurse. The Novak and Guest Care Burden Inventory and the short form of the World Health Organization Quality of Life Questionnaire were completed before and after the intervention. Data analysis was performed using chi-squared tests, independent sample t tests, and analysis of covariance. RESULTS: At baseline, the mean scores of care burden and quality of life were homogeneous between the two groups. After the intervention, the mean scores of care burden and quality of life were significantly reduced and improved in the intervention group compared with the control group (p < 0.001). CONCLUSIONS: Using the application with the ability to communicate with the caregiver, along with educational support, helps to strengthen the relationship between the family caregiver and the nurse. Despite the effectiveness of the present intervention, before including this form of implementation of support in care programs, it is necessary to evaluate its other positive aspects in future studies. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT), IRCT20210202050222N1. Registered on 05/02/2022.

Unexpected changes and associated factors of care burden among caregivers of cancer patients one year after COVID-19 outbreak.

Purpose: The study aimed to evaluate the changes in the care burden and quality of life of caregivers of cancer patients and correlates of care burden during the COVID-19 pandemic. Methods: This cross-sectional study used the census sampling technique with 260 cancer patients and their caregivers during January to March 2020 in northeast Iran. Data collection tools included the Novak and Guest Care Burden Scale, the SF-36 Quality of Life Questionnaire, and the Stress, Anxiety, and Depression Scale (DASS-21). Data were analyzed using descriptive and inferential statistics (independent t-test and multiple linear regression analysis). Results: Baseline scores of care burden and quality of life in caregivers suggested mild to moderate care burden and a reasonable quality of life and moderate levels of stress, anxiety, and depression in patients. The post-outbreak mean scores of care burden and quality of life significantly decreased and increased, respectively (p < .001). Regression analysis showed that 39.3% of the changes in the care burden score during the pandemic could be predicted by studied variables. In exchange for increasing the quality-of-life score and daily care hours, the care burden score decreases and increases. The burden of care in caregivers was also related to the type of cancer. Care burden in the caregivers of patients with breast and neurological malignancies was lower than the caregivers of patients with gastrointestinal cancer (p < .05). Conclusion: Despite the results obtained, supportive and educational interventions are needed to reduce the caregiver burden and improve the quality of life of caregivers and measure its impact on levels of psychological distress in their patients clinically.

Spiritual Well-Being and Death Anxiety: A Cross-Sectional Study Among Iranian Patients With Acute Coronary Syndrome.

Acute coronary syndrome (ACS) patients experience a tremendous psychological burden, typically in the form of death worry due to acute medical conditions and the possibility of mortality. The unfavourable conditions of ACS patients cause them to reconsider the meaning of life and their spiritual well-being. This study evaluated the association between death anxiety and spiritual well-being in a total of 241 ACS patients in Shahroud, northeast of Iran. The data were collected using the Templer Death Anxiety Scale, and the Spiritual Well-being Scale by convenience sampling method. All patients indicated a high degree of death anxiety, and roughly half reported a moderate level of spiritual well-being. There was a significant and direct correlation between death anxiety and spiritual well-being levels. Older age, single status, and non-smoking were other predictors of good spiritual well-being. A multidisciplinary health team should identify and implement approaches to promote spiritual well-being and reduce mental suffering.

Effect of support based on family centered empowerment model on care burden in family caregivers of patients with multiple sclerosis.

Introduction: Family caregivers of patients with multiple sclerosis (MS) are at risk of care burden that may lead to a detrimental effect on their quality of life (QoL), physical and mental well-being. This study aimed to determine the effect of the family-centered empowerment model (FCEM) on the care burden of caregivers of patients with MS. Methods: This quasi-experimental study was conducted using convenience sampling on 60 caregivers of patients referring to the Multiple Sclerosis Clinic in Ghaem Hospital, Mashhad, Iran. The participants were assigned to FCEM and control groups based on the days they were referred to the MS clinic. Data collection tools included the Zarit Caregiver Burden Inventory (CBI), completed in the intervention and control groups before and 1 month after the intervention. The support based on FCEM was provided during eight 45-60-min sessions, and the control group received the medical center's routine training. Data were analyzed by Chi-square, independent t-test, analysis of covariance, and repeated measure tests. Results: The results of the present study showed that all demographic characteristics were homogeneous at the baseline. Before the intervention, no significant difference was observed between the two groups regarding mean scores of care burden. Based on the repeated measure test, there was no significant treatment and time interaction in changes in care burden. Conclusion: The FCEM has no significant effect in alleviating the care burden. It is recommended to observe the necessary considerations regarding the context of this type of intervention and to carry out further investigations in different intervals.

Participatory management effects on nurses' organizational support and moral distress.

RESEARCH QUESTION/AIM/OBJECTIVES: Providing care for hospitalized children causes moral distress to nurses. Employee participation in discovering and solving the everyday problems of the workplace is one of the ways to hear the voices of nurses. This study aimed to evaluate the effect of participatory management programs on perceived organizational support and moral distress in pediatric nurses. RESEARCH DESIGN: A quasi-experimental study. PARTICIPANTS AND RESEARCH CONTEXT: The present study was conducted on 114 pediatric nurses in Iran. Data were collected using the Perceived Organizational Support Scale and the Moral Distress Scale of nurses. The intervention included implementing a participatory management program in three treatment departments that were randomly selected and it lasted 4 months. Participatory management was at the level of problem-solving with a focus on investigating, solving, and correcting issues and problems of work shifts and departments concerning the physical environment, equipment of the department, improvement of work processes, and team cooperation. In the control group, ordinary organizational approaches to problem-solving were used. ETHICAL CONSIDERATIONS: This study was approved by the Ethics Committee of Mashhad School of Nursing and Midwifery. Informed consent was obtained from the study participants. FINDINGS/RESULTS: Based on the results, both groups were homogenous before the intervention in terms of moral distress and perceived organizational support. The results showed that the moral distress mean scores in the intervention group decreased from 1.45 (0.52) to 1.03 (0.37) after the intervention. Also, the score of the perceived organizational support was 2.12 (1.2) increased after the intervention to 2.68 (1.10) in the intervention group. CONCLUSIONS: It was found that the participation of nurses in the problem-solving process to solve daily workplace issues can be effective in increasing their perceived organizational support and reducing their moral distress.

Efficacy of simulated video on test anxiety in objective structured clinical examination among nursing and midwifery students: A quasi-experimental study.

AIM: This research investigated the effectiveness of simulated video on test anxiety in the Objective Structured Clinical Examination (OSCE) among nursing and midwifery students. DESIGN: A quasi-experimental study with a two-group pre-test and post-test design. METHODS: This study was conducted on 118 nursing and midwifery students in Shahroud northeast of Iran in 2019 using the census sampling method. The intervention group received a 15-minute OSCE simulation video half an hour before the test. Data were collected using the Sarason test anxiety questionnaire in two stages: one week before the test and after the simulation film was screened. Data were analysed using descriptive and inferential statistics (Independent t-test, Chi-square, Exact fisher and Paired t-test). RESULTS: At baseline, no significant difference was observed between groups in the total mean score of test anxiety. The mean score of test anxiety significantly decreased in the OSCE simulation video group after the intervention.

Psychological distress as a predictor of the burden of care in family caregivers of COVID-19 patients in Iran: A community-based cross-sectional study.

Background and Aims: Coronavirus disease 2019 (COVID-19) has profoundly affected millions worldwide, including family caregivers of COVID-19 patients, in terms of caregiver burden and psychological distress. The present study aimed to evaluate the care burden and psychological distress among family caregivers, caring for a family member with COVID-19. Methods: The present study was performed with a cross-sectional design in the Shahroud community, northeast Iran using the convenience sampling method. A total of 297 family caregivers of COVID-19 patients were assessed using self-report scales including the depression, anxiety, and stress scale-21 and the Zarit burden interview to assess the symptoms of psychological distress (depression, anxiety, and stress) and caregiver burden. Data were analyzed using descriptive and inferential statistics (multivariate regression analysis). Results: Factors such as self-reported symptoms of depression (ß = 0.920, p < 0.001) and anxiety (ß = 0.712, p < 0.02) were significantly predicted care burden. Variables such as lower levels of education of the family member and caregivers and also the relationship between the caregiver and family member were additional predictive factors that aggravated the care burden. Conclusion: Caregivers of a family member with COVID-19 suffer significant levels of care burden that also results from psychological distress such as depression and anxiety. Therefore, appropriate psychoeducational interventions are highly recommended.

Acceptability, feasibility, and effectiveness of smartphone-based delivery of written educational materials in Iranian patients with coronary artery disease: A randomized control trial study.

Background and Aims: Providing education to patients with coronary artery disease (CAD) is one of the crucial roles of nurses and, there are various education methods for these patients. This study aimed to investigate the acceptability, feasibility, and effectiveness of smartphone-based delivery (SPBD) of written educational materials in Iranian patients with CAD. Methods: A total of 104 patients with CAD who were admitted to the cardiovascular unit of a large hospital in the northeast of Iran were randomly divided into control and intervention groups. When the standard educational content was provided, educational materials were delivered to the intervention group using a SPBD and to the control group using the routine print delivery (PD). The authors investigated the usability in the postintervention phase and information satisfaction and medication self-efficacy in the pre- and postintervention phases. Results: The mean age and the standard deviation of "patients" age in SPBD and PD groups was 51.8 ± 1.1 and 52.7 ± 1.3 years, respectively. No significant difference was observed between the two groups in terms of mean information satisfaction score (p = 0.726); however, the information satisfaction score was significantly higher in the SPBD group than PD group after the intervention (p = 0.012). The findings showed no statistically difference between two groups in terms of usability score (p > 0.05). The two groups were homogenous in terms of the mean medication self-efficacy score in the preintervention phase (p = 0.987); however, it was significantly higher in SPBD group than PD group in the postintervention phase (p = 0.045). Conclusion: The SPBD method had the same usability as the PD method and at the same time this method was more effective in promoting medication self-efficacy. Therefore, SPBD could be used to educate patients with CAD and their caregivers and have appropriate effectiveness and acceptability among the Iranian population.

Evaluating the effect of online psychoeducational support group on perceived stress in family caregivers of COVID-19 survivors.

INTRODUCTION: This study aimed to determine the effect of an online psychoeducational support group on the perceived stress of caregivers of coronavirus disease 2019 (COVID-19) survivors. METHODS: This randomized clinical trial included 70 caregivers of COVID-19 survivors discharged from Imam Reza Hospital in Mashhad, Iran in 2021. The intervention group received a psychoeducational support training program for stress management through six online group sessions (each 35-45 minutes) in a week. An expert psychiatric nurse provided this program on WhatsApp immediately after the patient's discharge from the hospital. The participants completed the Perceived Stress Scale (PSS-14) before starting the intervention and 1 week after that. Data analysis was conducted by descriptive and inferential statistics, including Chi-square, Fisher's exact test, independent, and paired t-test. RESULTS: Both groups were homogeneous in terms of demographic variables of survivors and caregivers. In terms of the PSS, there was no significant difference between the two groups before the intervention (p=0.28). The pre- and post-intervention scores of PSS in the intervention group were 39.57 ± 5.89 and 35.48 ± 5.68, respectively, indicating a significant decrease (p<0.001). Also, the pre- and post-intervention differences between the intervention and control groups were -4.08 ± 3.52 and -0.11 ± 2.66, respectively, indicating a greater decrease in the total PSS of the intervention group (p < 0.001). CONCLUSION: The family caregivers of COVID-19 survivors suffered from psychological distress during their patient care. It is recommended to perform online psychoeducational support group interventions for these individuals based on psychological and educational support program.

Effect of Local Warm Compression on Restless Leg Syndrome and Fatigue among Critical Care Nurses: A Parallel Randomized Clinical Trial.

Methods and Materials: This parallel randomized clinical trial was conducted on 120 CCNs in Shahroud by the census sampling method. Inclusion criteria included suffering from restless leg syndrome and having no wound or inflammation over the organ. The participants were assigned into two groups by the use of quadruple blocks. The intervention group received the warm compress for 12 sessions lasting 4 weeks and the control group did not receive an intervention. Data were collected using multidimensional fatigue inventory (MFI) and the Restless Legs Syndrome Scale and then analyzed using descriptive and inferential statistics (chi-squared test, independent sample t-test, and pair sample t-test). Results: The two groups were homogeneous in terms of demographic characteristics. Prior to the intervention, the two groups of warm compression and control did not have a significant difference in terms of mean fatigue and restless leg syndrome scores; however, after the intervention, a significant reduction was observed in the intervention group (p < 0.001). Conclusion: According to the results of the current study, the use of warm compression is an effective intervention in alleviating fatigue and restless leg syndrome, so it is recommended to implement this intervention as a nonpharmacological strategy among CCNs. Clinical Trial Registration Number. IRCT20190723044316N1.

Predictors of Self-Reported Compliance with COVID-19 Preventive Guidelines: A Quantile Regression Model.

The research used an online, convenience cross-sectional sample of adults aged ≥18 years old recruited from Shahroud County, Northeast of Iran. We measured the contribution of multiple determinants for association with behavioral compliance, at the time of the COVID-19 pandemic. The compliance score measured with this questionnaire can be within a range of 5 and 100. Compliance was bounded between 19 and 80 that has been distributed J-shape, so quantile logistic regression model has been fitted for that. Variables related to people's knowledge, including self-reported knowledge and following the news related to COVID-19, were the two main factors that accompanied behavioral compliance at all of its levels in the period of pandemic.

Health Care Providers' Attitudes Toward Do-Not-Resuscitate Order in COVID-19 Patients: An Ethical Dilemma in Iran.

This study aimed to investigate the health care providers' attitudes toward the Do-Not-Resuscitate order (DNR) in COVID-19 patients. This study was conducted on 332 health care providers (HCPs) at the COVID-19 referral hospital in Shahroud, Iran by convenience sampling method. The study tools included a demographic information form and the DNR attitude questionnaire. Significance level was considered 0.05 for all tests. The mean scores of attitudes toward DNR order, the procedure of DNR, some aspects of passive euthanasia, and religious and cultural factors were 25.27 ± 2.78, 40.61 ± 5.99, 11.26 ± 2.51, and 6.12 ± 1.27, respectively. The death of relatives due to COVID-19 and female gender were associated with high and low scores of attitudes toward DNR order, respectively. Extended working hours and more work experience were correlated with high scores of DNR procedure. The history of COVID-19 increased the mean score of attitudes toward some aspects of passive euthanasia. In addition, an increase in following COVID-19 news decreased the score of religious and cultural factors affecting DNR order. Despite the legal ban on implementation of the DNR in Iran, the attitude of Iranian HCPs toward this was positive in COVID-19 patients.

One-year changes in the prevalence and positive psychological correlates of depressive symptoms during the COVID-19 pandemic among medical science students in northeast of Iran.

OBJECTIVES: The COVID-19 pandemic has imposed a significant psychological burden on many across society especially students studying medical sciences. This study intended to investigate the one-year changes in the prevalence and correlates of depressive symptoms during the COVID-19 pandemic among medical science students. METHODS: A cross-sectional study in Shahroud, Iran administering a convenience sampling method (January to February 2021). Online self-reported questionnaires included Rosenberg Self-Esteem Scale, Paloutzian-Ellison Spiritual Well-Being Questionnaire, Diener's Satisfaction with Life Scale and the University Student Depression Inventory. Data analyzed using descriptive and inferential statistics (Independent t-test and Multiple Regression Analysis). RESULTS: A total of 306 medical science students were investigated in this study. The mean scores 1 year after the outbreak of COVID-19 were for depression (81.25 ± 26.04), spiritual well-being (80.98 ± 18.06), self-esteem (26.89 ± 2.20), and life satisfaction (19.68 ± 6.81). The results indicated that depression mean score was significantly higher in post outbreak assessment (71.92 ± 22.94 vs 81.25 ± 26.04) (P < .001). Fifty percentage of changes in depression can be predicted by studied variables. A high score of depression was directly associated with a higher level of self-esteem. Moreover, increased interest in the field, scores of spiritual well-being, and life satisfaction were inversely and significantly associated with depression. CONCLUSIONS: Iran's education system has been significantly affected, with the addition to the COVID-19 pandemic imposing a psychological burden such as depression, exacerbating this within medical science students compared to a year ago. Spiritual well-being and life satisfaction as positive psychology constructs were recognized as protective factors against depression during the pandemic. Spiritual and social support should be integrated in psychological interventions within university settings for medical science students.

Prevalence of Restless Legs Syndrome and Its Relationship with Fatigue in Critical Care Nurses.

BACKGROUND: The critical care unit is inherently stressful due to its complexity, leading to fatigue and consequences such as restless legs syndrome (RLS). This study aimed to investigate the prevalence of RLS and its relationship with fatigue in critical care nurses. PATIENTS AND METHODS: This cross-sectional study was performed with 200 nurses of critical care units of Shahroud hospitals in 2019 using the census sampling method. Data collection tools included the RLS questionnaire and the Multidimensional Fatigue Inventory. Data analysis was performed using descriptive and inferential statistics (multiple linear regression analysis). RESULTS: The results showed that 72% of the subjects had moderate to high RLS, and their mean fatigue was 55.31 ± 10.53. By increasing one point in the score of RLS and 1 year of critical care nursing experience, the fatigue score increases by 0.3 and 0.71. CONCLUSIONS: Considering the relationship between fatigue and RLS in critical care nurses, supportive interventions seem necessary to reduce the effects of these two components. HOW TO CITE THIS ARTICLE: Ameri M, Mirhosseini S, Basirinezhad MH, Ebrahimi H. Prevalence of Restless Legs Syndrome and Its Relationship with Fatigue in Critical Care Nurses. Indian J Crit Care Med 2021;25(11):1275-1279.

The effect of zinc supplementation on fatigue among elderly community dwellers: A parallel clinical trial.

BACKGROUND AND AIMS: Fatigue is one of the most common complaints of the elderly. This study was conducted to assess the effect of zinc supplements on fatigue among the elderly. METHODS: This randomized clinical trial was conducted on 150 elderly aged ≥60 years who were recruited from the health centers (Kashan, Iran) with a convenience sampling method. Participants were allocated to intervention and control groups by block randomization. Participants in the intervention group received a daily dose of 30 mg of zinc supplement for 70 days; meanwhile, in the control group, no intervention was performed. The level of fatigue was measured by the multidimensional fatigue inventory before and after the intervention. Both groups were homogeneous in terms of demographic variables, fatigue, and serum zinc level before the intervention. The significance level was considered as 0.05 in all tests. RESULTS: Zinc supplementation significantly reduced fatigue (mean difference: -10.41 vs 1.37, P < .001) and increased serum zinc level (mean difference: 14.22, vs -0.57, P < .001) compared to the control group. CONCLUSION: Consumption of zinc supplements for the elderly is recommended to overcome fatigue.

Effect of aromatherapy massage by orange essential oil on post-cesarean anxiety: a randomized clinical trial.

OBJECTIVES: Many women in recent years have been willing to undergo puncture surgery for childbirth, which, like other surgeries, has physical and psychological side effects such as incision, infertility, chronic pain, and anxiety. Therefore, it is important to reduce and improve these side effects. The aim of this study was to determine the effect of foot massage with orange essential oil on anxiety in women undergoing cesarean section. METHODS: This randomized clinical trial study was conducted in 2019 on 80 women referred to Bahar Shahroud Hospital after cesarean section surgery. The samples were divided into two groups by intervention (foot massage with orange essential oil) and control (foot massage without orange essential oil). The Spielberger scale was used to determine anxiety scores after cesarean section. In the intervention group, the feet were massaged with orange essential oil, and in the control group, the orange essential oil massage was performed without oil. Anxiety before, immediately after, and 60 min after the intervention was measured and evaluated in both groups. Data analysis was performed using descriptive and inferential statistics. Significant levels were considered for all statistical tests (p<0.05). RESULTS: The anxiety score before the intervention in the two groups of intervention and control was 57.12 ± 3.12 and 57.07 ± 3.54, respectively, which were not significantly different, but immediately after the intervention, the anxiety scores in both groups decreased significantly so that there was a further decrease in the intervention group (52.10 ± 4.75 and 56.02 ± 3.77), 1 h after the intervention, the anxiety score in the intervention group decreased compared to the previous stage and increased in the control group (50.40 ± 3.74 and 56.85 ± 4.27). CONCLUSIONS: Foot massage with orange essential oil can probably be effective as a proper nursing intervention in reducing anxiety after cesarean section surgery.