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.

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.

Effect of spiritual counseling on spiritual well-being in Iranian women with cancer: A randomized clinical trial.

OBJECTIVES: This study examined the effect of spiritual counseling on the spiritual well-being of Iranian women with cancer. DESIGN AND SETTING: a randomized clinical trial was conducted on 42 female cancer patients who were randomized to either an 8-week spiritual counseling intervention (n = 21) or a control group that received routine education/care (n = 21). Spiritual well-being (SWB) was assessed before and after the 8-week spiritual counseling program using Paloutzian and Ellison's (1983) Spiritual Well-Being Scale (SWBS). RESULTS: There were no significant differences on SWBS and its two subscales scores (RWB and EWB) between intervention and control groups at baseline (p > .05). After intervention, there was a significant mean difference in SWB (p = .001), RWB (p = .013) and EWB (p = .001) in two groups. CONCLUSIONS: Spiritual counseling is associated with significant improvements in SWB in Iranian women with cancer. Interventions that acknowledge the spiritual needs of these patients should be incorporated into conventional treatments.

Comfort and hope in the preanesthesia stage in patients undergoing surgery.

PURPOSE: Comfort and hope have been identified as important components in the care of perianesthesia patients. The purpose of this study was to explore the relationship between comfort and hope in the preanesthesia stage in patients undergoing surgery. DESIGN: A descriptive cross-sectional survey was conducted with 191 surgical patients. METHODS: Data were collected using the Perianesthesia Comfort Questionnaire and Herth Hope Index. FINDINGS: Direct and significant relationships were observed between comfort and hope (P≤.001, r=0.65). Also, significant relationships were observed between educational level and marital status with comfort (P≤.01). The relationship between educational level and hope was significant (P≤.001). Significant relationships were also observed between gender and marital status with hope (P≤.01). CONCLUSIONS: Overall, this study showed that a significant relationship exists between comfort and hope. Additionally, some demographic characteristics influenced comfort and hope in these patients. Health care providers should arrange the environment in a way that allows the surgical patients to experience comfort and hope and recognize the impact of personal characteristics when caring for surgical patients, particularly in the preanesthesia stage.

Prayer in Iranian cancer patients undergoing chemotherapy.

UNLABELLED: Chronic illnesses such as cancer are very stressful events and prayer is a valuable coping strategy for Muslim cancer patients. This study was conducted to assess the impact of prayer in Iranian cancer patients undergoing chemotherapy. A descriptive cross sectional survey was conducted on 360 cancer patients over 20 years of age who were able to read and write. Data collection employed Meraviglia's prayer questionnaire. Mean scores of prayer activity, prayer experience and attitude toward prayer were, respectively, (94.5+/-12.98), (51.2+/-7.49) and (38.2+/-4.84). Mean of total scores was (184.05+/-21.67). Significant relationships were observed between age, marital status and educational level with prayer activity, prayer experience and attitude toward prayer (P< or = 0.001). Also the relationship between sex and prayer activity was significant (P< or = 0.01). CONCLUSION: Individual characteristics had an important effect on prayer. It is suggested that health care providers can augment holistic care to these patients by encouraging prayer.