The effects of cold compress and transcutaneous electrical nerve stimulation on the pain associated with chest tube removal among patients with coronary bypass grafting.

BACKGROUND AND AIM: Chest tube removal (CTR) can cause severe acute pain which is usually described by patients as a painful experience. This study compared the effects of cold compress, transcutaneous electrical nerve stimulation (TENS), and combined cold compress-TENS on CTR-associated pain among patients with coronary artery bypass grafting (CABG). METHODS: This randomized controlled trial was conducted in 2018-2019 using a double-blind four-group design. Participants were 120 patients with CABG selected from Shafa hospital, Kerman, Iran, and randomly allocated to a cold compress, a TENS, a combined cold compress-TENS, and a placebo group (compress with room temperature) and TENS with an off TENS device. Each participant received the intervention for 15 min immediately before CTR. CTR-associated pain was assessed before, during, immediately after, and 15 min after CTR. Data were analyzed using the SPSS program (v. 22.0) at a significance level of less than 0.05. RESULTS: The data of 29 participants in the placebo group, 26 in the TENS group, 30 in the cold compress group, and 26 in the combined cold compress-TENS group was gathered. Baseline demographic and clinical characteristics and pain intensity scores of participants had no statistically significant differences among all four groups (P > 0.05). The mean score of pain intensity in all groups was at its highest level during CTR and gradually decreased afterwards, but this pain intensity reduction in the compress-TENS group was significantly greater than other groups (P < 0.001). CONCLUSION: Combined cold compress-TENS is more effective than separate cold compress and TENS in reducing CTR-associated pain among patients with CABG. Therefore, non-pharmacological methods such as combined cold compress-TENS are recommended for managing CTR-associated pain.

Comparison the effect of valerian and gabapentin on RLS and sleep quality in hemodialysis patients: A randomized clinical trial.

INTRODUCTION: This study aimed to compare the effect of valerian and gabapentin on restless legs syndrome (RLS) and sleep quality in HD patients. METHODS: In this cross over clinical trial study, 40 HD patients allocated into a valerian and gabapentin group. In the first phase of the study, Group A received valerian and Group B received gabapentin 1 h before bedtime for 1 month. In the second phase, the two groups' treatment regimen was swapped. After a 1-month washout period, the same process was repeated on the crossover groups. RESULTS: After the first phase, the mean score of RLS was lower in the gabapentin group. But there was no statistically significant difference between the two groups in terms of sleep quality score before and after the first and second interventions. CONCLUSION: Gabapentin is more effective than valerian in improving RLS, but both are equally effective in improving sleep quality.

Comparing the effects of auricular seed acupressure and foot reflexology on neonatal abstinence syndrome: A modified double blind clinical trial.

BACKGROUND: The neonates of addicted women are at risk for neonatal abstinence syndrome. This study aimed to compare the effects of auricular seed acupressure and foot reflexology on neonatal abstinence syndrome among the neonates of addicted women. METHODS: Thirty one neonates of addicted women were purposively recruited and randomly allocated through coin flipping to receive either foot reflexology then seed acupressure or seed acupressure then foot reflexology. Interventions were performed in two successive days with a 12-h washout interval. Foot reflexology was applied for 15 min to the first horizontal zone of the sole while seed acupressure was applied for 24 h through attaching acupuncture-specific ear seeds to the posterior surface of the auricle on the SJ 17 acupoint. The symptoms of abstinence syndrome were assessed using Finnegan Neonatal Abstinence Scoring System before and after foot reflexology, and before, 15 min, and 24 h after the onset of the seed acupressure intervention. Symptom assessment was done by a research assistant who was blind to the study intervention. FINDINGS: The mean score of abstinence symptoms for the foot reflexology intervention significantly reduced from 10.32 ±â€¯2.10 at pretest to 7.87 ±â€¯2.04 at posttest (P < 0.001). Moreover, the mean score of abstinence symptoms for the seed acupressure intervention significantly reduced from 9.70 ±â€¯2.10 to 8.70 ±â€¯1.46 at the first posttest (P = 0.007) and 7.32 ±â€¯1.42 at the second posttest (P < 0.001). The change in the mean score of the foot reflexology intervention was significantly greater than the change in the mean score at the first seed acupressure posttest (P < 0.001) but did not significantly differ from the change in the second seed acupressure posttest (P = 0.880). CONCLUSION: Both foot reflexology and auricular seed acupressure has significant effects on abstinence symptoms. Of course, 15-min seed acupressure is less effective than 15-min foot reflexology, while 24-h seed acupressure is as effective as 15-min foot reflexology in alleviating abstinence symptoms.

Comparison of Effects of Local Anesthesia and Two-Point Acupressure on the Severity of Venipuncture Pain Among Hospitalized 6-12-Year-Old Children.

The aim of the present study was to compare the effects of topical anesthesia and acupressure at the Yintang (Extra 1) and the Laogong (P-8) points on the severity of venipuncture pain among hospitalized 6-12-year-old children. A sample (n = 120) of 6-12-year-old hospitalized children was recruited from two teaching hospitals located in Rafsanjan, Iran. The children were allocated to the topical anesthesia, acupressure, and control groups. For children in the topical anesthesia and the acupressure groups, eutectic mixture of local anesthetic (EMLA) cream and two-point acupressure were used, respectively, prior to performing venipuncture, whereas children in the control group only received routine prevenipuncture care. The severity of venipuncture pain was evaluated 5 minutes after performing venipuncture by using the Face, Leg, Activity, Cry, and Consolability behavioral pain assessment scale. The findings revealed that pain severity in both experimental groups was significantly lower than that in the control group, whereas there was no significant difference between the experimental groups regarding pain severity. Although acupressure was as effective as topical anesthesia cream in alleviating children's venipuncture pain, nurses are recommending to use acupressure instead of pharmacological pain management agents because of its greater safety, cost-effectiveness, and applicability.

Effect of Acupressure on Symptoms of Postoperative Ileus After Cesarean Section.

Postoperative ileus (POI) is a common complication after most abdominal surgeries including cesarean section. It is associated with longer hospitalization and increased medical costs. This study is a randomized controlled trial investigating the effect of acupressure, and low-cost noninvasive traditional treatment, on POI symptoms after cesarean section. A total of 120 patients were randomly divided into two groups; the treatment group received two sessions of acupressure (an hour after attending the women's division; and 3 hours after the first session), each lasting 20 minutes. The time of flatus and defecation, time to presence of bowel sounds, and duration of postoperative bed rest were monitored. Patients in the treatment group had a shorter time to presence of bowel sounds compared with those in the control group (p<0.001), as well as shorter time to first passage of flatus (p<0.001) and shorter postoperative bed rest (p=0.005). However, the time to first defecation was not statistically significant (p=0.311). Acupressure has potential positive impacts on attenuating POI symptoms after cesarean section, and can be used as a low-cost noninvasive nursing care to reduce POI incidence and intensity after cesarean section.

Spirituality: A Panacea for Patients Coping with Heart Failure.

BACKGROUND: Many patients with heart failure grapple with related problems that threaten their feeling of well-being and quality of life. Patients look for ways to cope with the new situation. The present study aimed to explore religious coping from the perspective of patients with heart failure. METHODS: This qualitative study used the content analysis of the semi-structured interviews. The data were collected from 18 participants referring to training hospitals in Kerman University of Medical Sciences in southeastern Iran. The data were analyzed using Lundman and Graneheim qualitative content analysis. RESULTS: The main theme of "Spiritual coping, a dominant strategy" was extracted with two categories: 1- "religious belief" having the sub-categories of "inner faith" and "search of meaning" 2- "connection to God as the supreme power" with sub-categories of "seeking healing through supplication and rituals", "worship as a barrier to the flood of problems", and "submission to and trust in God". CONCLUSION: The findings suggest that a spiritual strategy helps the patients effectively to cope with heart failure. Patients learn to use religious beliefs and faith to accept the reality of the disease and its stages and to manage their condition with patience, tolerance, and hope calmly and confidently for a bright future.