Effects of balance training on cognitive function and activities of daily living in older adult patients with heart failure: a randomized controlled trial.

BACKGROUND: The potential of the effect of balance training on improving cognitive functions and functional activities in vulnerable groups, including the older adults with heart failure (HF), is unknown. AIM: The aim of the present study was to determine the effect of a simple balance training supervised by nurses on cognitive functions and activities of daily living (ADLs) of the older adults with HF. METHODS: In this clinical trial study, 75 older adults with HF were allocated to two groups of balance training (BT) and usual care (UC) using stratified block randomization. The intervention consisted of a set of dynamic and static BT, 4 times/session per week, each session lasting 30 min, for 8 weeks, which was performed at the participant's home under the supervision of a nurse. For the control group, UC was provided. The outcomes of the study, including cognitive function, basic ADLs, and instrumental ADLs (IADLs), were measured by the Montreal cognitive assessment-basic (MoCA-B), Barthel index-ADL, and Lawton scale-IADL before and after the intervention. RESULTS: The between-group analysis showed, in two groups, a statistically significant difference between the changes in the mean scores: all subscales of cognitive function and MoCA-B total score (P < 0.001), as well as basic ADLs and IADLs (P < 0.001), before and after the intervention. Compared with the control group/UC, the cognitive function, basic ADL, and IADL of the intervention group/BT were improved significantly at 8 weeks. CONCLUSION: The results suggested that home-based balance training led by nurse can improve global cognitive function and basic ADL and IADL in the older adults with HF. TRIAL REGISTRATION: Clinical trials registration number IRCT20150919024080N18.

Effect of aromatherapy with Melissa essential oil on stress and hemodynamic parameters in acute coronary syndrome patients: A clinical trial in the emergency department.

Stress and hemodynamic changes are among the most significant symptoms and signs that could be observed in patients with acute coronary syndrome (ACS) upon admission to the emergency department. The present study was conducted to determine the effect of the fragrance of lemon balm (Melissa Officinalis) essential oil on stress level and hemodynamic parameters in patients with ACS in the emergency department. METHODS: In this double-blind clinical trial, 72 patients were allocated to two groups of Melissa and placebo based on stratified block random sampling. The Melissa group inhaled two drops of Melissa essential oil, whereas the placebo group inhaled two drops of sunflower oil in two aromatherapy phases for 10 min with 90-min intervals. Stress level was measured using the depression, anxiety and stress scale (DASS-21), and hemodynamic parameters were measured and recorded in six time points by a cardiac monitoring system. Data analysis was carried out using descriptive statistics and ANOVA statistical tests, Chi-square test, independent t-test, and post-hoc Tukey's test. RESULTS: Interaction between the time and group indicated the significant decrease in the mean score of stress and heart rate in the time points 2 and 5 (5 min after every occasion of aromatherapy) (p < 0.001) and also the remarkable decrease in the mean arterial pressure (MAP) in the time point 2 in the Melissa group in comparison with the placebo group (p < 0.001). There were no significant differences between the mean changes in stress, heart rate and MAP in the two group (P > 0.05). CONCLUSION: Aromatherapy via the inhalation of Melissa essential oil with temporary impacts on certain time points could relieve stress and regulate hemodynamic changes in patients with ACS in emergent and acute conditions.

Effects of multiepisode case-based learning (CBL) on problem-solving ability and learning motivation of nursing students in an emergency care course.

BACKGROUND: Meeting the learning needs and developing the thinking skills of nursing students in caring for injured patients with complex, emergency, and unpredictable conditions is essential. PURPOSE: The present study aimed to compare the effects of case-based learning (CBL) with multi-episode case studies and lecture-based learning (LBL) on the perceived problem-solving ability and learning motivation of undergraduate nursing students in an emergency care course. METHODS: This study was conducted with a quasi-experimental, within-subjects, pretest-posttest design. Forty-three third-year undergraduate nursing students (as a single cohort) enrolled in the fall semester were selected using convenience sampling. The theoretical course of emergency nursing was taught to them using the LBL method (control group) during the first six weeks of the semester and then using the CBL method (intervention group) during the second six weeks of the semester through multi-episode cases in five steps. Outcomes including perceived problem-solving ability and learning motivation were measured using the Problem-Solving Inventory (PSI) and the Instructional Materials Motivation Scale (IMMS). RESULTS: There was a significant difference (P < 0.001) between the changes in the total mean score of perceived problem-solving ability and its subscales on the three measurement points, i.e. before lectures (pre-test), after lectures (mid-term test) and after CBL (final test). There was a significant difference between the LBL and CBL groups in terms of the students' total learning motivation score (t = 16.91, P = 0.000) and all its subscales after the CBL intervention. CONCLUSION: The study suggests that the CBL method applied through multi-episode cases is an effective approach to improving the perceived problem-solving ability and learning motivation of nursing students.