A Comparison of the Effects of Acupressure and Music on Venipuncture Pain Intensity in Children: A Randomized Controlled Clinical Trial.

Pain from injections is common in children of all ages, and more than 90% of hospitalized children experience invasive and painful procedures such as venipuncture. In light of the complications associated with pain relief medications, nonpharmacological and complementary medicine approaches have gained attention. This study aims to compare the effects of acupressure and music on venipuncture pain intensity in children. This randomized controlled clinical trial involved 180 children aged 3-6 years who sought treatment at the Children's Medical Center Hospital Emergency Department at Tehran University of Medical Sciences, Iran. The children were randomly assigned to one of three groups: acupressure, music, or control. The interventions were given within 5 minutes, starting 3 minutes before the venipuncture and continuing until completion. The interventions included playing music through headphones and applying acupressure to the Hugo point. Venipuncture was carried out under identical conditions using an Angiocath 24G needle. Pain intensity was assessed using the Oucher scale. Data were analyzed using SPSS 24, employing the Kruskal-Wallis, chi-square, and Bonferroni pairwise comparison tests, with a significance level of 0.05. The mean pain intensity was 3.32 ± 1.44 in the music group, 4.82 ± 1.51 in the acupressure group, and 8.32 ± 1.10 in the control group. Pain intensity significantly differed among the three groups (p < 0.001). Specifically, pain intensity was lower in the music group compared to both the acupressure (p < 0.001) and control (p < 0.001) groups. Furthermore, pain intensity was lower in the acupressure group than in the control group (p < 0.001). Based on the results, music and acupressure methods effectively reduce pain intensity during venipuncture in children. Considering that music demonstrated a more pronounced effect in alleviating venipuncture pain than acupressure, the recommendation is to utilize music as a method of pain management during venipuncture in children. Iranian Registry of Clinical Trials, Trial No. IRCT20120109008665N15, was registered on 6 December 2021.

The Effect of the Holy Quran Recitation on Inflammatory Markers in Hemodialysis Patients in Iran: A Randomized Clinical Trial.

Increased inflammation is a common complication in chronic hemodialysis (HD) patients. Addressing the psychological symptoms of patients may help reduce inflammation and its negative impact on the body. Considering the calming effects of listening to the Holy Quran, this may help reduce mental, psychological, and physical problems in Muslim patients. The present study sought to examine the effects of listening to Holy Quran recitation on the level of inflammatory markers in HD patients. This was a randomized controlled trial involving 50 HD patients at Kowsar Hospital in Semnan, Iran, in 2019-2020. The participants were divided into experimental and control groups using simple randomization by sealed envelopes. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6) levels in blood were measured before the intervention. The participants in the experimental group listened by headphones to the Holy Quran being recited three times a week, 20 min each time, for one month. For those in the control group, headphones were placed but on silent mode. At the end of the intervention one month later, inflammatory markers were measured again for participants in both groups. Data were analyzed in SPSS-16 using descriptive and inferential statistics (t test, Wilcoxon, and Mann-Whitney U). Mean IL-6 level decreased by 20.2 pg/ml, mean ESR level by 16.8 mm/hr, and mean CRP level by 19.9 mg/dl in the experimental group, while these values increased in the control group. The between-group differences in the intervention and control groups at follow-up were significant for all three inflammatory markers (p < 0.05). Listening to the Holy Quran being recited is recommended as a complementary therapy for reducing systemic inflammation (as indicated by inflammatory markers) in Muslim HD patients.Trial registration: Iranian Registry of Clinical Trials, Trial No: IRCT20120109008665N9. Registered 4 Nov 2019.

Nursing Students' Professional Competence in Providing Spiritual Care in Iran.

Providing spiritual care as a dimension of holistic nursing care is a task that requires competent caregivers. The present study seeks to examine the relationship of personal characteristics with perceived competence in Iranian nursing students and their professional competence in providing spiritual care. This cross-sectional study was conducted on all the nursing students at Semnan University of Medical Sciences, Semnan, Iran, using the census method (n = 224). The research sample consisted of 179 students who met the eligibility criteria. Data were collected using the Spiritual Care Competence Scale (SCCS). The mean SCCS score for respondents was 3.66. Using the cutoff point of >3.5, approximately three quarters of respondents (72.1%) perceived themselves to be competent in delivering spiritual care. The scores of competence and its domains were not significantly different in terms of history of participation in ethics training workshops, gender and marital status (P > 0.05). The scores were also not significantly correlated with age, semester and work experience. Although more than 70% of the nursing students perceived themselves competent in providing spiritual care, nursing curriculum planners should seek to promote the spiritual capacity and competence of nursing students in providing spiritual care through education and training.

Effect of foot reflexology on chest pain and anxiety in patients with acute myocardial infarction: A double blind randomized clinical trial.

BACKGROUND AND PURPOSE: The aim of this study was to determine the effect of foot reflexology on chest pain and anxiety in patients with AMI. MATERIALS AND METHODS: This study was a double blind randomized clinical trial. Stratified random sampling was carried out on 90 patients with AMI in the three groups of treatment, placebo and control. Foot reflexology was done for three consecutive days, each time for 20 min. Chest pain and anxiety were evaluated with Visual Analogue Scale before, immediately and 20 min later. RESULTS: 20 min after the intervention, severity of chest pain in treatment group was significantly lower than control group (p < 0.001) and placebo group (p = 0.002). Severity of anxiety between groups and at different times was not significant. CONCLUSIONS: Foot reflexology was effective in attenuating chest pain, had the most effect in 20 min after intervention, and can be used to relieve chest pain in patients with AMI.

The effects of acupressure on the symptoms severity and function status and electrodiagnostic findings in patients with carpal tunnel syndrome.

OBJECTIVE: This study aimed to evaluate the effects of acupressure on the symptoms severity, function status and electrodiagnostic findings in patients with Carpal tunnel syndrome (CTS). DESIGN: This double blind, randomized, controlled clinical trial study was conducted on 57 patients with CTS that selected through convenience sampling. The patients were randomly assigned to three groups, including (1) acupressure; (2) placebo acupressure; and (3) control. SETTING: The study was conducted in the medical centers affiliated to Semnan University of Medical Sciences, Iran. INTERVENTION: The intervention groups received acupressure or placebo for one month. The control group received only routine cares (splints and analgesics) with no additional intervention. PRIMARY OUTCOMES: The severity of symptoms and hand function were evaluated by the Boston Carpal Tunnel Syndrome Questionnaire, and electrodiagnostic findings, including Nerve Conduction Velocity (NCV), Distal Sensory Latency (DSL), and Distal Motor Latency (DML) were measured by Electromyography device before and after the intervention. RESULTS: The results showed significant differences in the mean severity of symptoms, hand function, NCV, DSL, and DML before and after the intervention in the acupressure group (P < 0.05). Significant differences were also observed between the means difference in severity of symptoms, hand function, and NCV, DSL, and DML before and after the intervention in the three groups (P < 0.05). CONCLUSION: According to the results, acupressure was effective in reducing the severity of clinical symptoms, improving the hand function, and improving the electrodiagnostic findings. Therefore, the application of acupressure can be recommended for improving clinical symptoms of patients with CTS.

The Effect of Spiritual Care Based on the Sound Heart Model on the Spiritual Health of Patients with Acute Myocardial Infarction.

Meeting the spiritual needs of patients with cardiovascular diseases has a significant effect on their speed of recovery and spiritual health, especially in coronary care units (CCUs). The present study was conducted to investigate the effect of spiritual care based on the sound heart model on the spiritual health of patients with acute myocardial infarction (AMI) admitted to the CCU of Chamran Hospital in Isfahan, Iran, in 2016. This clinical trial was conducted on 92 patients with AMI selected by convenience sampling and randomly assigned to the intervention (n = 46) and control (n = 46) groups. The spiritual care program based on the sound heart model was regularly carried out for the intervention group over 3 days at 5-8 PM during their hospital stay, and continued for 1 month at home after discharge from the hospital, and the control group only received routine nursing interventions. The patients completed Paloutzian and Ellison's Spiritual Well-Being Scale at baseline and a month after the intervention. Data were ultimately analyzed using Fisher's exact test, Mann-Whitney's test, the Chi-square test, and the t test. The spiritual care program was able to improve the mean scores of religious health (7.8), existential health (9.3) and the total score of spiritual health (17.1) in the intervention group, while these scores reduced to 0.9, 3.4 and 4.2 in the control group. A significant difference was found between the intervention and control groups in terms of the spiritual health score (P < 0.001). The present findings confirmed the effect of spiritual care based on the sound heart model on promoting spiritual health in patients with AMI. Its application as a holistic care approach is therefore recommended for improving the signs and dimensions of spiritual health in patients with coronary artery disease, especially MI.

Comparing acupressure with aromatherapy using Citrus aurantium in terms of their effectiveness in sleep quality in patients undergoing percutaneous coronary interventions: A randomized clinical trial.

INTRODUCTION: Poor sleep quality is prevalent in candidates for percutaneous coronary interventions (PCIs). The present study was conducted to compare aromatherapy with acupressure in terms of their effectiveness in sleep quality in patients undergoing PCIs. MATERIALS AND METHODS: The present study was conducted on 85 patients undergoing PCIs and randomly assigned, using block randomization, to five groups, namely (1)aromatherapy, (2)placebo aromatherapy, (3)acupressure, (4)placebo acupressure (acupressure applied to a point not traditionally associated with improving sleep) and (5)control. The intervention groups received aromatherapy or acupressure or placebo from 10pm to 8am the following day. The control group received only routine care. Sleep quality was measured in the patients using a visual analog scale (VAS) that was completed by them before and after the intervention. RESULTS: The mean pretest score of sleep quality was 2.91 ±â€¯0.53 in the aromatherapy group, 2.84 ±â€¯0.47 in the placebo aromatherapy group, 2.98 ±â€¯0.59 in the acupressure group, 2.75 ±â€¯0.41 in the placebo acupressure group and 2.88 ±â€¯0.41 in the controls. ANOVA suggested no significant differences among these groups in the pretest (P = 0.746). The mean posttest score of sleep quality was 3.72 ±â€¯1.84 in the aromatherapy group, 3.70 ±â€¯1.83 in the placebo aromatherapy group, 7.35 ±â€¯0.99 in the acupressure group, 2.67 ±â€¯0.41in the placebo acupressure group and 2.72 ±â€¯0.34 in the controls, suggesting significant differences among the five groups based on the ANOVA results showed significant differences among the five groups (P < 0.001). The mean posttest score of sleep quality was higher than the pretest score by 4.37 in the acupressure group compared to in the other groups (P < 0.001). CONCLUSION: The present findings provided scientific evidence for the benefits of using different methods, including acupressure, for sleep quality in patients undergoing PCIs. IRANIAN REGISTRY OF CLINICAL TRIALS NUMBER: IRCT201707248665N6.

Effect of valerian on cognitive disorders and electroencephalography in hemodialysis patients: a randomized, cross over, double-blind clinical trial.

BACKGROUND: The prevalence of cognitive disorders in hemodialysis patients is twice as high as the general population, while these disorders often are undiagnosed. Timely prevention and treatment can improve their personal and social functions. Aim of study was determined the effect of Valerian on cognitive disorders and electroencephalography (EGG) in hemodialysis patients. METHODS: This crossover, double-blind clinical trial was conducted on 39 hemodialysis patients. The patients were randomly divided into two groups. Group A (n = 19) took Valerian capsules and Group B (n = 20) received placebo capsules 60 min before bedtime for one month. The type of treatment was replaced between the two groups after a one-month wash-out. The Mini Mental State Examination (MMSE) questionnaire was completed and EGG was performed before and after intervention in both periods. RESULTS: The cognitive scores of the Group valerian were increased significantly in the first (p = 0.003) and the second (p = 0.005) periods. In addition, the mean increase in the cognitive scores in the Group valerian was significant in the first (p = 0.028) and the second periods (p = 0.030). However, the changes in EGG showed no significant difference before and after intervention in two groups. CONCLUSION: The findings of this study indicated that valerian could be effective and significantly improve patients' cognitive status; however, no significant changes were observed in the electroencephalography of the hemodialysis patients. TRIAL REGISTRATION: IRCT201606076318N7 -2016-06-17.

Attitudes Toward Spirituality and Spiritual Care among Iranian Nurses and Nursing Students: A Cross-Sectional Study.

Addressing spiritual needs is taken into account as an integral part of holistic health care and also an important component of nursing practice. The aim of present study is to evaluate attitudes toward spirituality and spiritual care among nurses and nursing students at Semnan University of Medical Sciences in Iran. In this cross-sectional study, all nurses (n = 180) working in the teaching hospitals affiliated to Semnan University of Medical Sciences as well as senior nursing students (n = 50) selected by the census method. Finally, 168 individuals meeting the inclusion criteria were evaluated as the study sample. The data collection instrument was the Spirituality and Spiritual Care Rating Scale. The mean and standard deviation scores of attitudes toward spirituality and spiritual care among nurses and nursing students were 59 ± 10.9, and the scores obtained by the majority of study population (64.3%) ranged between 32 and 62 which were at a moderate and relatively desirable level. Nurses and nursing students working in aforementioned hospitals reported positive attitudes to spirituality and spiritual care. Given the importance of spiritual care and also the moderate level of spirituality and spiritual care among nurses and nursing students in this study, institutionalization of the concept of spirituality, provision of an appropriate context to deliver such care, and also implementation of interventions in order to improve spiritual care along with other nursing skills were assumed of utmost importance.

The effect of topical application of lavender essential oil on the intensity of pain caused by the insertion of dialysis needles in hemodialysis patients: A randomized clinical trial.

BACKGROUND: Patients undergoing hemodialysis experience constant fear and anxiety due to the pain of the insertion of dialysis needles, which might lead to certain physiological and psychological complications for them in the long term. It is therefore essential to control their pain through a simple, safe method. OBJECTIVE: The present study was conducted to determine the effect of the topical application of lavender essential oil on the intensity of pain during the insertion of dialysis needles in hemodialysis patients. DESIGN: This open crossover study was conducted on 34 hemodialysis patients with arteriovenous fistula (AVF) admitted to the dialysis unit of one of the hospitals of Semnan University of Medical Sciences in 2013. The intensity of pain was measured in all the patients in three different states during the insertion of arterial needles for hemodialysis: (1) The topical application of 100% lavender essential oil, (2) no intervention, (3) placebo (with water). MAIN OUTCOME MEASURES: Pain intensity was measured in this study through the numeric rating scale (NRS) of pain. RESULTS: The findings showed that the mean±SD of pain intensity was 2.91±1.69 with the topical application of lavender, 4.59±2.02 in the no intervention state and 4.18±1.66 with the placebo state. Statistical tests showed a significant difference between the patients' intensity of pain in the three different states (p=0.001). CONCLUSION: Based on the findings of the study, the topical application of lavender decreases moderate intensities of pain during the insertion of dialysis needles. Accordingly, lavender oil may be an option to reduce pain by insertion of hemodialysis needles.

Effect of omega-3 fatty acids on intensity of primary dysmenorrhea.

OBJECTIVE: To examine whether dietary supplementation with omega-3 fatty acids relieved symptoms of primary dysmenorrhea. METHODS: Women aged 18-22 years with primary dysmenorrhea were enrolled in a double-blind crossover study. Women assigned to group 1 (n=47) received 1 omega-3 capsule daily for 3 months, followed by placebo for 3 months. Women in group 2 (n=48) received placebo for 3 months, followed by omega-3 for 3 months. A washout period was performed in both groups. Participants used 400mg of ibuprofen as a rescue dose if severe menstrual pains were experienced. RESULTS: A marked reduction in pain intensity was observed after 3 months of treatment with omega-3 fatty acids (P<0.05). Women who received omega-3 fatty acids required fewer rescue doses than women who received placebo (P<0.05). The mean numbers of ibuprofen tablets used after 3 months with omega-3 fatty acids were 4.3±2.1 (group 1) and 3.2±2.5 (group 2); the mean numbers of tablets used after 3 months of placebo were 5.3±2.2 (group 1) and 6.0±2.6 (group 2) (P=0.001 for both). CONCLUSION: Supplementation with omega-3 fatty acids reduced the symptom intensity of primary dysmenorrhea. Supplementation efficacy was sufficient to decrease the ibuprofen rescue dose.

Effect of different doses of folic acid on serum homocysteine level in patients on hemodialysis.

INTRODUCTION: Hyperhomocysteinemia is common in patients with end-stage renal disease. It is one of the risk factors for cardiovascular disease. We evaluated the effect of different doses of folic acid on serum homocysteine level in patients on hemodialysis. MATERIALS AND METHODS: Patients on maintenance hemodialysis were randomized into 4 groups to receive oral folic acid at doses of 2, 5, 10, and 15 mg/d, each for a period of 4 weeks. Serum homocysteine level was measured in all of the patients before and at the end of each week of therapy. Folic acid supplementation was discontinued during a washout period of 1 week between each of the four phases of the trial. RESULTS: Thirty-one hemodialysis patients completed the four phases of treatment with each dose of folic acid (17 women and 14 men). The mean age of patients was 57.6 ± 14.6 years. Serum homocysteine level was reduced significantly compared to its basal level after treatment with folic acid at different doses (P < .001). Different doses of folic acid were not significantly different in lowering serum homocysteine levels. CONCLUSIONS: Our study failed to show any difference between high-dose and low-dose folic acid therapy regarding their effect on serum homocysteine level. It seems folic acid, 2 mg/d, is an adequate dose, and there is no need to administer a higher dose of it.