Comparing the Effect of Foot and Hand Reflexology on Pain Severity after Appendectomy: A Randomized Clinical Trial.

BACKGROUND: Appendicitis is one of the main causes of acute pain. The aim of this study was to determine the effects of foot and hand reflexology on pain severity following appendectomy. MATERIALS AND METHODS: This clinical trial was conducted on 38 patients undergoing appendectomy in Alimoradian Hospital of Nahavand, Iran, in 2016. The samples were selected using convenience sampling, and then, randomly assigned to hand and foot reflexology groups via simple random sampling. In the foot reflexology group, the dorsal and plantar surfaces of the feet were lubricated using natural olive oil for five minutes. Next, reflexology was done by applying pressure to the appendix reflex area for 20 minutes. The same intervention was applied in the hand reflexology group. The severity of pain was measured using a Visual Analog Scale (VAS) before the intervention and one, three, and 24 hours after the intervention. Data were analyzed using Chi-square, One-way Analysis Of Variance (ANOVA), and repeated measures ANOVA. RESULTS: The results of one-way ANOVA showed no significant difference in the mean pain severity between the two groups (p = 0.771), whereas pain severity in the foot reflexology group was significantly lower than that of the hand reflexology group after the intervention (t = 1.63, p = 0.001). CONCLUSIONS: The results of this study showed that foot reflexology was more effective than hand reflexology in pain alleviation.

Nasal high-frequency oscillatory ventilation (nHFOV) versus nasal continuous positive airway pressure (NCPAP) as an initial therapy for respiratory distress syndrome (RDS) in preterm and near-term infants.

BACKGROUND: Currently, various forms of non-invasive respiratory support have been used in the management of respiratory distress syndrome (RDS) in preterm neonates. However, nasal high-frequency oscillatory ventilation (nHFOV) has not yet been applied commonly as an initial treatment. OBJECTIVES: This study was designed to investigate the efficacy and safety of nHFOV compared with nasal continuous positive airway pressure (NCPAP) in preterm and near-term infants with RDS. METHODS: In a randomised clinical trial, a total of 68 neonates (gestational age (GA) between 30 and 36 weeks and 6 days) with a clinical diagnosis of RDS were randomly assigned to either the NCPAP (n=34) or the nHFOV (n=34) group. The primary outcome was the duration of non-invasive respiratory support (duration of using NCPAP or nHFOV). RESULT: The median (IQR) duration of non-invasive respiratory support, was significantly shorter in the nHFOV group than that in the NCPAP group (20 (15-25.3) versus 26.5 (15-37.4) hours, respectively; p=0.02). The need for a ventilator occurred in 4 out of 34 (11.8%) neonates in the NCPAP group and in none of the neonates in the nHFOV group (p=0.03). In addition, intraventricular haemorrhage (IVH) occurred in nine cases (6.9%) in the NCPAP group and two cases (3.3%) in the nHFOV group, which showed a significant difference (p=0.04). The incidence of pneumothorax, chronic lung disease, pulmonary haemorrhage and necrotising enterocolitis was similar between the two groups. CONCLUSION: This study showed that nHFOV significantly reduced the duration of non-invasive respiratory support and decreased the need for intubation compared with NCPAP in infants with RDS. Furthermore, nHFOV seems to reduce the incidence of IVH without increasing other complications. TRIAL REGISTRATION NUMBER: IRCT2017062734782N1.

The effect of presence of family members on the anxiety level of candidates for esophagogastroduodenoscopy: A randomized controlled trial.

Background: Anxiety and its control is a public health problem worldwide. This study was conducted to determine the effect of family members' presence on the anxiety level of patients who were candidates for esophagogastroduodenoscopy (EGD). Methods: This randomized controlled trial study was performed in Shahid Chamran hospital in city of Saveh in IR Iran. In this study, 96 patients who were candidates for EGD and met the inclusion criteria were assigned into control and intervention groups by simple random sampling method. The demographic questionnaire and Spiel Berger's State and Trait Anxiety Questionnaire (STAI) were used to measure anxiety. Results: No significant difference was found between the 2 groups in the mean level of anxiety before intervention (p= 0.13). After intervention, the level of anxiety decreased significantly in the intervention group (p= 0.001). However, the mean level of anxiety was not significant in the control group after intervention (p= 0.09). Conclusion: The results of the present study showed that the presence of family members during endoscopy may reduce the patient's anxiety level, and thus it is recommended as a non-pharmaceutical, beneficial, and safe intervention.

Reflexology as an adjunctive nursing intervention for management of nausea in hemodialysis patients: A randomized clinical trial.

INTRODUCTION: Nausea is common side effect of hemodialysis. Nonpharmacological methods such as reflexology or other branches of integrative medicine can be used to control nausea. The aim of this study was to determine the effect of reflexology on nausea in hemodialysis patients. METHODS: This study was a double-blind randomized clinical trial conducted from March 2018 to June 2018 at the Arak Dialysis Center, Iran, in which 72 eligible hemodialysis patients were randomly assigned into intervention (n = 36) and control (n = 36) groups. Reflexology was performed on the solar plexus and soles of the feet once (30 min per session) per day for twelve days, one hour after the onset of hemodialysis in the area of nausea on the solar plexus and on the soles of the feet. RESULTS: The results showed there was no significant difference in severity of nausea (P = 0.28) between the two groups before intervention. However, after intervention the severity of nausea in the 3rd, 6th, 9th, and 12th days in the intervention group was significantly lower than the control group. CONCLUSIONS: The results showed that reflexology had a positive effect on reducing the severity of nausea in hemodialysis patients. Therefore, reflexology is recommended as part of nursing care to reduce patient suffering. Universities can train students in reflexology and managers can use the protocols to apply this method to reduce patient discomfort during hemodialysis.

Infographics or video; which one is more effective in asthmatic patients' health? a randomized clinical trial.

Objective: Asthma disease is a complex medical condition for which the control of symptoms depends on sufficient patient knowledge, self-care, and adherence to medication protocols. Researchers conducted this study to evaluate the impact of infographics and video on asthma patients' adherence to medication. Methods: A randomized clinical trial in which 80 asthmatics were enrolled and allocated to two study groups (infographic and video groups). Researchers used questionnaires to gather demographic data. A nurse assessed Morisky adherence to medication. Researchers performed data analysis using repeated measurements and Least Significant Difference (LSD) in SPSS software version 23. Results: There was no significant difference between the two study tracks (P > 0.05) in the demographic data and adherence to medication in the pretest. The differences between the two intervention groups throughout the one-month follow-up were statistically significant (P < 0.05). There were significant differences between the two intervention groups in pretest and post-test, and pretest and follow-up (P < 0.05). However, there were no significant differences between the two intervention groups in post-test and follow-up (P > 0.05). Conclusions: According to the study findings, both the infographic and video formats may have led to an increase in adherence to medication protocols among asthma patients; but it seems that the infographic format is preferred for long- term use because it does not require usage of a facility. However, education format of asthmatic people is dependent on conditions and patient preferences.

Determinants of adherence to self-care behavior among women with type 2 diabetes: an explanation based on health belief model.

BACKGROUND: Self-care is an essential element in treating a person with diabetes; and managing diabetes is of prime importance. The aim of this study was to investigate the predictors of adherence to self-care behavior among women with Type 2 diabetes. METHODS: This cross-sectional study was conducted on 210 female patients aged 30 to 60. Data collection tool was an anonymous valid and reliable questionnaire designed based on the Health Belief Model (HBM), which acquired information about the followings: Perceived susceptibility, severity, benefits, barriers, self-efficacy and diabetes self-care behavior. Data were analyzed by t-test, chisquare and regression analysis. RESULTS: The multiple regression models revealed 59.9% of the variance of self-care behavior with self-efficacy, perceived barrier, benefit and susceptibility. Additionally, the highest weight for ß (ß=0.87) was found for self-efficacy. Self-care behavior was positively correlated with all HBM variables except for perceived barriers showing a negative correlation. CONCLUSION: The Health Belief Model may be used as a framework to design intervention programs in an attempt to improve adherence to self-care behaviors of women with diabetes. In addition, the results indicated that self-efficacy might play a more crucial role in developing self-care behaviors than t other HBM components. Therefore, if the focus is placed on self-efficacy when developing educational programs, it may increase the likelihood of adherence to self-care behavior.

Health locus of control and self-care behaviors in diabetic foot patients.

BACKGROUND: Diabetic foot affects more than 25% of diabetic patients and finally up to 20% of cases result in amputation. The most important factor resulting in severe complications or even death is lack of self-care. Health locus of control has been introduced as one of health factors and predicting factors of self-care. This research was performed for analyzing the correlation between self-care behaviors and health locus of control in diabetic foot patients. METHODS: In this descriptive study, 120 patients with diabetic foot were chosen using convenience sampling from endocrine clinic and wards of endocrine and vascular surgery of Teleqani Hospital of Shahid Beheshti Medical University. The data were gathered by demographic, self-care behavior, and health locus of control questionnaires. The t-test, analysis of variance (ANOVA) and spearman coefficient were used to analyze the data. RESULTS: RESULTS of this research showed that there is a direct and significant relation between selfcare behaviors and internal health locus of control (p<0.001), and also in contrast with chance health locus of control (p<0.001). CONCLUSION: We have to consider these factors' role in nursing interventions and patient-care education programs and plans. Probably, interventions and programs that will lead to the strengthening of internal health locus of control improve and strengthen patients' self-care behaviors and their involvement in treatment.