Development and psychometric evaluation of a tool to assess oncology nurses' occupational health needs.

BACKGROUND: Oncology nurses are confronted with various occupational hazards; consequently, it is of great importance to identify and measure their occupational health needs. Due to the fact that standard tools are not available to assess these needs, this study was conducted to develop a tool for assessing oncology nurses' occupational health needs. MATERIALS AND METHODS: This study consisted of two phases from 2020 to 2021. The first phase was item generation and tool design. The initial development of the item pool was based on the result of the qualitative study and literature search. The second phase was item reduction and psychometric evaluation of the formulated tool including, face, content, and construct validity and reliability. Construct validity was assessed using exploratory factor analysis and convergent validity with the participation of 300 oncology nurses. The reliability of the tool was assessed using internal consistency (Cronbach's alpha) and test-retest (intra-cluster correlation coefficient). RESULTS: The mean content validity index (CVI) of the tool was 0.95. The results of exploratory factor analysis showed that this tool consisted of 69 items and four factors, explaining 65.88% of the variance. The results of the convergent validity assessment showed a significant positive correlation between the mean scores of occupational health needs and occupational stress (P < 0.0001 and r = 0.40). Cronbach's alpha coefficient (0.98) and tool stability (0.98) confirmed the appropriate reliability of the tool. CONCLUSION: The developed tool is recommended as a valid and reliable tool for assessing oncology nurses' occupational health needs that can be used both in practice and in future studies.

Care needs of adults with spinal trauma in the prehospital and hospital setting from the perspective of patient care team: A qualitative research.

BACKGROUND: Appropriate care of patients with definite spinal cord injury or at risk of it in the prehospital and hospital stages requires comprehensive planning in the health system. It is also the requirement of any successful program to explain the needs from the perspective of its stakeholders. Thus, this study aimed to discover the care needs of adults with spinal trauma in prehospital and hospital settings from the perspective of the patient care team. MATERIALS AND METHODS: This qualitative study was conducted with the participation of urban and rural prehospital emergency personnel and emergency departments of educational and therapeutic hospitals affiliated to Isfahan, Tehran, Shiraz, Kermanshah, Ahvaz, and Yasuj Universities of Medical Sciences, through conducting 36 in-depth semi-structured interviews from September to December 2021. Using purposive sampling method, the participants were selected considering the maximum variation. The data saturation was reached after conducting interviews and group discussions with 36 subjects. Data were analyzed using conventional content analysis approach. Lundman and Graneheim approach were used for the study rigour. Data were simultaneously analyzed using MAXQDA software version 10. RESULT: During the data analysis, two themes of prehospital care with two main categories (emergency care and management of secondary complications of spinal trauma) and hospital care with two main categories (emergency care and management of secondary complications of spinal trauma) emerged. CONCLUSION: Emergency care and management of secondary complications of spinal cord injury in the prehospital and hospital stages can affect treatment results, improve quality of life, and reduce mortality rate, secondary injuries, and healthcare costs. Thus, identification of the care needs of the adults with spinal trauma from the perspective of the patient care team can help the authorities to plan appropriate interventions.

Incidence of cervical collar-related pressure injury in patients with head and neck trauma: A scoping review study.

The use of the cervical collar to support the head and neck is inevitable in many patients with head and spinal cord injuries. One of the consequences of using this instrument is the development of pressure injuries. Therefore, in this review study, the incidence of as well as the risk factors for cervical collar-related pressure injury in this group of patients was evaluated. The current study is a scoping review conducted in 2022. Five scientific databases (PubMed, Scopus, Web of Science, ProQuest, and CINAHL), as well as Google Scholar, were searched for relevant studies published from 1990 to 2022 using the following keywords: trauma, spinal cord injury, head injury, head trauma, collar, cervical collar, cervical immobilization, risk factors, incidence, pressure injury, pressure ulcer, and bed sore. The search was performed independently by two researchers. Articles from the initial search were first recorded in special tables, and then, were reviewed and analyzed separately by two researchers. After extraction, information from each article was entered into a special table categorized by year, country, study design, study population, the incidence of cervical collar-related pressure injury, risk factors for cervical collar-related pressure injury, and grades of pressure injury. Of the 10 articles, 6 were retrospective cohort studies, 3 were cross-sectional descriptive studies, and 1 was a case report study. In terms of the study population, one study was conducted on pediatric patients, one was conducted on elderly patients, and eight were conducted on adults with head and neck trauma. In eight articles, the incidence of cervical collar-related pressure injury was reported. The reported incidence varied between 1.1% and 78.4%. In eight articles, risk factors for cervical collar-related pressure injury were reported. The most common risk factors were duration of cervical collar use, hospitalization in intensive care units, low level of consciousness, and longer hospital stay. The current review study showed that a significant percentage of head and neck trauma patients for whom cervical collar is used suffer from different grades of pressure injuries. Hence, healthcare providers should consider this issue when caring for this group of patients and take the necessary preventive measures in this regard. It should be noted that previous studies in this field had significant limitations, and thereby, it is strongly recommended to conduct further studies with a stronger methodology.

Active aging needs from the perspectives of older adults and geriatric experts: a qualitative study.

Introduction: With an increasing rate of population aging and its consequences, preparation for active aging based on older adults' needs is an unavoidable priority. Active aging needs must be identified to help strategic planning for older adults' health and wellbeing. This study aimed to explore the active aging needs from the perspectives of older adults and geriatric experts. Methods: This exploratory-descriptive qualitative study was conducted in four provinces with the oldest populations in Iran. Semi-structured and focus group interviews were conducted with 41 participants (20 older adults and 21 geriatric experts), who were chosen through purposive and snowball sampling. Data were analyzed using the conventional content analysis. Results: This study identified three themes and thirteen categories from the data: (1) basic individual needs with three categories of physiological, psycho-emotional, and spiritual needs; and (2) managerial needs with seven categories of political-legal, socio-economic, and cultural-spiritual infrastructures, academic strategies, an age-friendly environment; technological services, and provision of specialized services and daycare for older adults, and (3) educational needs with three categories of training self-care and self-efficacy, empowering the health care workers; and empowering the family. Conclusion: The results revealed personal, managerial, and educational needs for active aging and could assist policymakers and geriatric experts to promote and meet active aging needs successfully.

Impact of Telenursing on Blood Pressure and Body Mass Index of People with Prehypertension: A Randomized Controlled Clinical Trial.

BACKGROUND: Prehypertension is an important global health challenge. This study determines the effect of telenursing on Blood Pressure (BP) and Body Mass Index (BMI) in patients with prehypertension. MATERIALS AND METHODS: This randomized controlled clinical trial study included 81 patients with prehypertension discharged from an emergency room at Isfahan University of Medical Sciences (Iran) in 2016. Participants joined a session about hypertension, risk factors, and lifestyle modification to reduce its risk. Using a random number table, 41 subjects were assigned to the experimental group and 40 subjects to the control group. Only the experimental group received four SMS messages each week and a 10-15 min phone call once a month to help them change their lifestyle and reinforce their health behaviors. Eventually, patients' information was collected, and the data were analyzed using independent t, paired t, and Chi-square tests. RESULTS: The experimental group after the intervention had a significantly lower mean (Standard Deviation [SD]) of Systolic Blood Pressure (SBP) (from 126.67 [5.15] to 119.21 [5.72] [t 40 = 8.40, p < 0.001]) and Diastolic Blood Pressure (DBP) [from 85.28 (2.29) to 78.79 (4.16) (t 40 = 10.02, p < 0.001)]. However, the same means were not significantly different in the control group [SBP (p = 0.116) and DBP (p = 0.096)]. The mean (SD) of changes between BMI before and after the intervention was -0.75 (0.66) in the experimental and 0.042 (0.41) in the control group, which was significantly different between the two groups (t 79= -6.44, p < 0.001). CONCLUSIONS: Telenursing can have potential benefits to maintain BP within the normal range and reduce BMI in patients with prehypertension.

Exploring the occupational health needs of oncology nurses: A qualitative study.

BACKGROUND: Although the work environment of oncology nurses is highly complex and challenging, their occupational health needs are scarcely studied. This study aimed to explore the occupational health needs of oncology nurses. MATERIALS AND METHODS: This qualitative descriptive study was conducted in 2018-2019. The participants consisted of 52 oncology nurses and 11 other key informants. They were chosen from eight cancer treatment centers in different cities of Iran. Data were collected through semi-structured individual interviews and analyzed using conventional content analysis. RESULTS: The occupational health needs of oncology nurses were grouped into three main categories included needs for self-care, development of professional competency, and a safe and healthy work environment. CONCLUSION: The work environment of oncology nurses needs to be optimized in terms of physical, psychological, organizational, and sociocultural conditions. Furthermore, the necessary measures should be taken to encourage oncology nurses to implement self-care, thus creating the preparedness to face the challenges of the workplace by developing their professional competencies.

Occupational stressors in oncology nurses: A qualitative descriptive study.

AIM AND OBJECTIVES: The present study aims at exploring oncology nurses' perceptions regarding work-related stressors. BACKGROUND: Oncology nurses work in an environment with a high degree of stress, which can negatively affect their health. There is limited research on work-related stressors from the oncology nurses' perspective. DESIGN: Qualitative descriptive study. METHODS: Fifty-two oncology nurses were selected purposefully from eight cancer treatment centres in different cities of Iran. Data were collected through semi-structured interviews and analysed using conventional content analysis. The COREQ checklist was used to document the report of the study. RESULTS: The extracted contents were classified into four main categories. The first category involved personal ability with two subcategories (person-job fit and psychological competencies). The second category included physical environment arrangements with two subcategories (physical working conditions and equipment and facilities). The third category involved psychosocial safety in the workplace with four subcategories (creating a safe work environment, overcoming the challenges of providing care to cancer patients, work/life balance and social recognition of the nursing status). The fourth category holds an organisational context with four subcategories (organisational support, interpersonal relations, justice at work and human resources). CONCLUSION: It is necessary to find measures attenuating work-related stresses in oncology nurses. These measures should be in line with developing personal abilities in nurses and creating a safe environment in terms of optimising physical, psychosocial and organisational conditions. It is also important to develop programmes protecting the oncology nurses' occupational health. RELEVANCE TO CLINICAL PRACTICE: The results of this study can help improve nursing work conditions, attenuate work-related stresses in nurses and introduce efficient interventions reducing occupational stressors.

Oncology Nurses' Needs Respecting Healthy Work Environment in Iran: A Descriptive Exploratory Study.

OBJECTIVE: The work environment of oncology nurses is often unpleasant due to the complexities of cancer treatment and care. Yet, there is limited information about their perspectives on healthy work environment (HWE) and their HWE-related needs. This study aimed to explore oncology nurses' HWE-related needs. METHODS: This descriptive exploratory qualitative study was conducted in 2018-2019. Participants were 52 nurses and 11 oncology specialists, nursing instructors and managers, and occupational and environmental health experts, who had the experience of promoting nurses' work conditions. They were recruited from eight teaching specialty cancer treatment centers in different cities of Iran (Tehran, Isfahan, Mashhad, Shiraz, and Babolsar). Data were collected via semi-structured interviews. Data were analyzed via conventional content analysis. RESULTS: Oncology nurses' HWE-related needs were grouped into the four main categories of physical-structural improvement, mental health improvement in work environment, organizational improvement, and sociocultural improvement. CONCLUSIONS: A wide range of physical-structural, mental health, organizational, and sociocultural improvements should be made to oncology nurses' work environment in order to fulfill their HWE-related needs. Health-care managers can use the findings of the present study to create HWE for oncology nurses.

Prevalence of pre-hypertension and hypertension, awareness, treatment, and control of hypertension, and cardiovascular risk factors in postmenopausal women.

BACKGROUND: Pre-hypertension (HTN) and HTN are risk factors for cardiovascular disease (CVD). Despite its importance, HTN is often underestimated and undiagnosed, especially in women. This study was designed to determine the prevalence of pre-HTN and HTN among a large sample of Iranian menopausal women. METHODS: This repeated cross-sectional study was conducted on 1013 menopausal women aged 41 to 85 years in Isfahan, Iran, in the years 2001, 2007, and 2016. The participants were selected through multistage cluster random sampling. Awareness, treatment, and control of HTN were assessed using a validated researcher-made questionnaire. Blood pressure was determined via an arm digital blood pressure monitor. RESULTS: The prevalence of HTN in the years 2001, 2007, and 2016 was 52.6%, 49.0%, and 51.6%, respectively; no significant changes were observed (P > 0.05). The prevalence of pre-HTN in these years was 56.6%, 53.3%, and 42.2%, respectively. In 2001 and 2007, respectively, 28.8% and 50.4% of menopausal women had HTN controlled by medication, and in 2016, 86.6% of women were aware of their disease and 62% of them had controlled HTN (P < 0.001). CONCLUSION: The results showed that HTN and pre-HTN were highly prevalent among Iranian menopausal women and markedly increased with age. Interventional population-based approaches are needed to improve knowledge and efficient practice that may help to lower the risk of HTN and CVD in this at-risk population.

Comparison of multiple blood pressure frequency methods with optimum blood pressure measurement among Iranian individuals.

BACKGROUND: Proper blood pressure (BP) measurement frequency method is less evaluated to optimize hypertension (HTN) status among different nations due to cultural patience variations. The aim of this study was to compare the first (BP1), second (BP2), and the mean of first and second (BP1,2) and all the three (BP1,2,3) with the second and third BP measurements in Iranian individuals. MATERIALS AND METHODS: This cross-sectional study was done on 2264 individuals aged 18 years or more living in Isfahan city, Iran. Their BPs were assessed from right arms by the standard tools and methods after 5 min of rest in a quiet room by a trained staff. The mean second and third readings were considered as reference, and the other aforementioned variables were compared with it. RESULTS: The mean age of total population was 40.9 ± 16.1 years (males: 52%). Men had significant higher means of systolic BP (SBP) and diastolic BP (DBP) with any measurement frequency methods than women (P < 0.001 and P = 0.009). Considerable clinical significant (≥5 mmHg) ranges were mostly observed in BP1 compared with BP2,3. SBP2 and DBP2 indices showed insignificant differences compared with reference mean. Moreover, abnormal BP levels (≥140/90 mmHg) were mostly observed in terms of BP1 measurement with no remarkable variability in BP2 reading in comparison to the reference. CONCLUSION: Our considerable data suggested that BP2 could appropriately categorize BP status similar to BP2,3 and it may be rational for physicians considering this mean and excluding the first BP measurement as a sole criterion for HTN assessment in Iranian adults. Multiple researches are necessary quantifying appropriate frequencies of BP reading.

The effect of a lifestyle management educational program on blood pressure, heart rate, and body mass index in patients with hypertension.

BACKGROUND: Hypertension (HTN) is one of the most prevalent risk factors for arteriosclerosis and coronary artery disease (CAD). Its side effects can be decreased through the use of some methods and interventions. The present study was conducted with the aim to evaluate the effects of a lifestyle management on blood pressure, heart rate, and body mass index (BMI) of patients with HTN who have undergone angioplasty. METHODS: This clinical trial was conducted on 2 groups in 3 stages in an educational hospital in Isfahan, Iran, in 2014. The study participants consisted of 60 patients with HTN who had undergone angioplasty. The participants were randomly allocated to the study and control groups. The intervention was implemented in 6 educational sessions during 3 weeks, and then, follow-up was conducted through phone calls in the study group. The collected data were analyzed using independent t-test, chi-square, Mann-Whitney U test, and ANOVA in SPSS software. RESULTS: Repeated measures ANOVA results indicated that the effect of time (P < 0.001) and group (P = 0.027) on systolic blood pressure (SBP) was significant. The effect of time (P = 0.015) and group (P = 0.040) on diastolic blood pressure (DBP) was also significant. In terms of BMI, both effects of time (P = 0.010) and group (P = 0.034) were significant. However, the effect of time (P = 0.899) and group (P = 0.900) on heart rate was not significant. CONCLUSION: The lifestyle management program implemented in the present study was effective on decreased DBP, SBP, and BMI in patients with HTN who had undergone angioplasty. Thus, nurses could implement this program as a part of their care provision program for patients.

The Effect of Henna (Lawsonia Inermis) on Preventing the Development of Pressure Ulcer Grade One in Intensive Care Unit Patients.

BACKGROUND: Detecting pressure ulcer is an important nursing diagnostic and care requirement in patients hospitalized in Intensive Care Unit (ICU). The purpose of this study is to examine the effect of Lawsonia plant on pressure ulcer grade one in ICU patients. METHODS: In this clinical trial, 72 patients eligible for hospitalization in hospitals of Isfahan University of Medical Sciences were divided randomly into two control and intervention groups. The standard program of skin care was implemented on both groups; in addition, a mixture of Lawsonia (henna) and distilled water was applied topically in the intervention group. The classification form of the International Pressure Ulcer Advisory Panel was used to identify grade one ulcers. Data were collected on the 1st day through demographic information questionnaire and Braden pressure ulcer risk assessment scale. An infrared thermometer was used to record local temperature of the ulcers on a daily basis. Assessments were made based on Pressure Ulcer Scale for Healing (PUSH), and the pressure ulcer area was examined per square centimeter on the 1st, 4th, and 7th days. The data were analyzed using SPSS 16. RESULTS: The average change in the ulcer area per square centimeter in the control group increased by 29.9 ± 37.93 whereas it decreased by 3.54 ± 33.91 in the intervention group. The mean PUSH score decreased in the intervention group (5.36 ± 3.12) while it increased in the control group (1.91 ± 1.53). The average changes of PUSH score before and after the intervention showed a significant difference in both groups. CONCLUSIONS: With regard to the effect of henna on the reduction of ulcer area and the average PUSH score in ICU patients, the application of henna is recommended for healing grade one pressure ulcers.

A clinical trial on the effect of a multifaceted intervention on blood pressure control and medication adherence in patients with uncontrolled hypertension.

BACKGROUND: Hypertension (HTN) is the key risk factor for cardiovascular diseases (CVDs). The purpose of this study was to determine the effect of a multifaceted intervention on blood pressure (BP) control and medication adherence (MA) among patients with uncontrolled HTN. METHODS: A randomized controlled clinical trial study was conducted on 72 patients in the emergency ward who were selected through convenience sampling method. They were randomly divided into intervention and control groups. The studied multifaceted intervention includes motivational interviews and 90 minutes of training sessions, use of a drug reminder box, family support, and 4 phone call follow-ups. The8-Item Morisky Medication Adherence Scale (MMAS-8) was used before and after the intervention. BP was measured in both groups before and after the intervention and compared between them. RESULTS: No significant difference existed between the two groups in terms of MA and systolic and diastolic BP before the study. The differences between the mean changes in post-intervention systolic (-25.75 ± 19.39 vs. -2.88 ± 11.92 mmHG; P < 0.001) and diastolic (-6.18 ± 8.87 vs. -1.06 ± 8.70 mmHg; P = 0.010) BP in the intervention and control groups were statistically significant. The mean changes in post-intervention MA in the intervention and control group was 2.91 ± 1.64 and -0.36 ± 1.15, respectively; this difference was statistically significant (P < 0.001). CONCLUSION: The studied multifaceted intervention promoted MA and reduced systolic and diastolic BP. Thus, the use of this method as a supplementary treatment is recommended after patient discharge.

Comparing the Effect of Henna Oil and Olive Oil on Pressure Ulcer Grade One in Intensive Care Units Patients.

BACKGROUND: One of the most common problems in the intensive care unit (ICU) is the incidence of pressure ulcer or bedsore. This research was conducted with the aim to compare the effect of henna and olive on pressure ulcer grade one in ICU patients hospitalized in the selected hospitals of Isfahan University of Medical Science in 2016. MATERIALS AND METHODS: This study conducted on 108 ICU patients with pressure ulcer. Patients were randomly divided into three groups. The two intervention groups were treated with olive oil and henna oil, respectively, and the third group was the control group. Data were collected using a demographic information questionnaire, Braden pressure ulcer risk assessment scale, and a table for daily record of the skin temperature before and within 1 week of the study. Data were analyzed in SPSS 22 using independent t-test, repeated-measures ANOVA, and Fisher's exact test. RESULTS: The results showed a significant difference between the two henna and olive groups in the mean score of pressure ulcer measured through the pressure ulcer scale for healing tool (P < 0.05). The mean area of the ulcer on days 4 and 7 in the henna oil group was lower than that in the olive oil and control groups (P < 0.001). CONCLUSION: The results of this study showed that both henna and olive oils were effective in healing the pressure ulcer. However, henna oil showed better results in reducing the area of pressure ulcers over time.

Development and evaluation of the psychometric properties of a hypertension self-care questionnaire.

BACKGROUND: There are a number of tools to assess self-care in hypertension (HTN), but they do not cover all the dimensions of self-care and do not have a good reliability and validity. This study was conducted to develop and evaluate the psychometric properties of a tool for self-care assessment in HTN. METHODS: This cross-sectional, methodological study was conducted in Isfahan, Iran. An expert panel was held to assess the qualitative face validity of the tool. The content validity ratio (CVR) and content validity index (CVI) were measured. The questionnaire was distributed among 20 patients to measure its internal reliability. After 14 days, it was re-distributed among the same patients, as a measure of external reliability. The questionnaire was completed by 203 patients with HTN and an exploratory factor analysis was performed in order to assess the construct validity of the tool. RESULTS: The items of the self-care tool were confirmed with a CVR ≥ 0.5, Kappa ≥ 0.71, I-CVI = 0.69, and intraclass correlation coefficient (ICC) = 0.952. The factor analysis showed that the 16-item questionnaire has 5 dimensions, including follow-up [3 items; factor loadings (FL) = 0.619 to 0.869, and Cronbach's alpha (α) = 0.737], healthy lifestyle (5 items; FL = 0.709 to 0.846, α = 0.703), promoting qualifications (4 items; FL = 0.610 to 0.791, α = 0.594), medication therapy (2 items; FL = 0.699 and 0.740, α = 0.717), and following recommendations (2 items, FL = 0.577 and 0.744, α = 0.701). These 5 dimensions explained 62.686% of the variance. The Cronbach's alpha coefficient of the final self-care assessment questionnaire was 0.833. CONCLUSION: The developed questionnaire proved to have appropriate psychometric properties for measuring self-care in patients with HTN.

Effect of Family-Patient Communication on the Incidence of Delirium in Hospitalized Patients in Cardiovascular Surgery ICU.

BACKGROUND: Cardiovascular diseases are the most important causes of morbidity and mortality in the world, and cardiac surgery is one of the treatments that have complication for patients. One of the most important current psychological complications after cardiac surgery is delirium. For its prevention and treatment, considerable attention should be paid to the role of family. This study has been conducted for assessing the effect of the relationship between the family and patient on the incidence of delirium in hospitalized patients in cardiovascular surgery intensive care unit (ICU) of Isfahan Shahid Chamran hospital. MATERIALS AND METHODS: This study is a two-group, single-blind (for the questioner) clinical trial that was conducted among 68 patients in the cardiac surgery ICU of Shahid Chamran hospital affiliated to the Isfahan University of Medical Science in 2013. Sampling was convenient sampling, and the patients were allocated to two groups (n = 34 patients) based on random numbers table. The day after the surgery, one of the family members in the intervention group who had received education the day before was allowed to visit the patient in the morning shift. In the control group, patients received routine care. Two groups were assessed for delirium twice a day for a total of three times (two times in the morning and one time in the evening) with use of Richmond Agitation Sedation Scale and Confusion Assessment Method -ICU (CAM - ICU) scale. RESULTS: In the intervention group, 41.18% patients were females and 58.82% patients were males, and in the control group, 29.42% patients were females and 70.58% were males. Mean and SD of patients' age in the intervention group was 55.11 (12.11) and in the control group 54.12 (13.11) years. Based on study results, incidence of delirium in the morning after surgery (second day) in intervention group was 11.76%, and in control group it was 23.53%. In the third day, it was 8.83% in intervention group and 20.58% in control group. Chi-square test showed a significant difference in incidence of delirium during the second (P = 0.04) and the third (P = 0.03) days of surgery in the two groups. In the control group, the incidence of delirium in the evening was 32.35%, which was more than that in the morning. Cochran test showed a significant difference in the morning and afternoon shifts in the control group (P = 0.004). CONCLUSIONS: Effective communication between the patient and family, as a nonmedical method, can reduce delirium after cardiac surgery, especially, at the end of the day; nurses should pay more attention to the prevention of delirium.

Design and implementation of a combined observational and interventional study: Trends of prevalence, awareness, treatment and control hypertension and the effect of expanded chronic care model on control, treatment and self-care.

BACKGROUND: Lack of information about hypertension leads to failure in detection, treatment and reduced estimation of this disease effects. So, a comprehensive study, named trends of prevalence, awareness, treatment and control hypertension among the adults in Isfahan, Iran (2001-2016) and evaluation of the effect of expanded chronic care model (ECCM) on control, treatment and self-care, has been designed. This study explains the aspects of design and methods of its implementation. METHODS: This study was conducted in four stages in 2014-2016. In the 1st stage, valid questionnaires were made to assess knowledge, attitude and practice, and self-care. In the 2nd stage, the status of prevalence, awareness, treatment and control and hypertension risk factors was assessed. In the 3rd stage, a two-group clinical trial was conducted to evaluate the effectiveness of ECCM on hypertensive patients and their families. In the 4th stage, the results of hypertension prevalence and its risk factors in adults in 2016 were compared with two other studies undertaken in 2001 and 2007. RESULTS: To develop the questionnaire, face and content validity, internal and external reliability, and construct validity were examined. Prevalence, awareness, treatment and control of hypertension and risk factors among 2107 adult individuals were determined in Isfahan. In a clinical trial, 216 hypertensive patients were randomly assigned into intervention and control groups. Finally, a sample size of 8073 people was used to determine and compare the 15-year-old trend of hypertension and its affecting factors. CONCLUSION: It is obvious that the final findings of this study will play a key role in health and research policy and provide a suitable model for implementing appropriate interventional measures at the provincial and national levels.

Effects of a Lifestyle Modification Program on Knowledge, Attitude and Practice of Hypertensive Patients with Angioplasty: A Randomized Controlled Clinical Trial.

BACKGROUND: Lack of knowledge, attitude and practice are some of the barriers of having a healthy lifestyle and controlling high blood pressure. This study aimed to determine the effectiveness of a lifestyle modification program on knowledge, attitude and practice of hypertensive patients with angioplasty. METHODS: This study was a randomized controlled clinical trial conducted from November to April 2014 on 60 hypertensive patients with angioplasty in Shahid Chamran hospital of Isfahan, Iran. The samples were randomly assigned to two equal groups. Data collection was performed in three stages by a researcher-made questionnaire. The intervention plan was 6 education sessions and then follow up were done by phone call. The gathered data were analyzed via SPSS (V.20), using t-test, Chi-square, repeated measurement, and post hoc LSD test and ANOVA statistics. RESULTS: The mean score of knowledge, attitude and practice in the experimental group immediately after the intervention was 77.8±7.2, 88.3±6.4 and 86.2±6.5, respectively and one month after the intervention was 80.8±7.4, 91.1±3.5 and 92.5±2.2, respectively. But in the control group, the mean score of knowledge, attitude and practice immediately after the intervention (34.90±11.23, 61.11±6.28, and 38.64±7.15) and one month after the intervention was (38.64±7.15, 59.56±6.31 and 37.27±7.26. CONCLUSION: Lifestyle modification program can be effective in promoting the knowledge, attitude and practice of hypertensive patients with angioplasty. Nurses can use this program in their care provision programs for these patients. Trial Registration Number:IRCT2015062420912N3.

The effect of saline lock on phlebitis rates of patients in cardiac care units.

BACKGROUND: Despite advances in the field of intravenous therapy, phlebitis is still a common complication of peripheral venous catheter and finding an appropriate solution to prevent and reduce the incidence of this complication remains challenging. One of the methods used in reducing the incidence of phlebitis is the use of saline lock, which is forgotten in most hospitals. Therefore, this study aimed to evaluate its impact on the incidence and severity of phlebitis. MATERIALS AND METHODS: In a single-blind (the researcher) clinical trial, 88 patients with peripheral venous catheter admitted in cardiac care units in selected hospitals of Isfahan University of Medical Sciences, Iran, were selected through convenient sampling method. They were randomly divided into two groups of intervention and control groups using random number table. The intervention group received 3 ml of 0.9% normal saline sterilized before and after each intravenous drug or every 12 h. However, in the control group, the intravenous drugs were given as routine and saline lock was not used. The evaluation of intravenous catheter regarding the incidence of phlebitis and its degrees using Jackson's Visual Infusion Phlebitis Scale was performed 6 times within 72 h (every 12 h). Results were evaluated by SPSS software using descriptive statistics, Chi-square test, t-test, and Mann-Whitney test. RESULTS: Results showed that there was a statistically significant difference between the two groups regarding the degree of phlebitis (P = 0.003). The percentage of phlebitis incidence in the control group was 88.6% and in the intervention group was 43.2%. There was a statistically significant difference between the two groups (P < 0.001). The risk of incidence of phlebitis in the group without saline lock (control), compared to the intervention group, was 10.3 times greater (CI = 95%). The incidence of phlebitis in both groups increased with increase in the duration of catheter placement. CONCLUSIONS: The results of this study showed that the use of saline lock in the intervention group compared to the control group, in which saline lock was not used, can have a significant impact on reducing the incidence of phlebitis and its degree.