Comparison of Single and Combined Effects of Nature Sounds and Foot Sole Reflexology Massage on the Level of Consciousness in Traumatic Comatose Patients: A Randomized Controlled Clinical Trial.

Consciousness disturbances are the most common posttraumatic complications. The purpose of this study was to compare the single and combined effects of nature sounds and foot sole reflexology massage on level of consciousness in traumatic comatose patients. This randomized controlled clinical trial was conducted in 2 teaching hospitals in an urban area of Iran. Samples were 120 traumatic comatose patients who were randomly assigned into control, nature sounds, foot reflexology massage, and nature sounds plus foot sole reflexology massage groups. Patients in all groups received routine care. Interventions were performed twice a day for 2 weeks, each time for 30 minutes. The patients' level of consciousness was assessed using the Glasgow Coma Scale before, 1 week, and 2 weeks after the intervention. The groups had no significant differences in the mean scores of the consciousness level before, 1 week after, and the last day of the intervention. Also, there was a significant difference in the number of patients who regained full consciousness (P = .001) in the intervention groups compared with the control group. Significant differences in the number of days of consciousness were reported in at least one of the groups compared with other groups (P = .001). This difference was significant in the control group compared with the foot reflexology massage group (P = .032), as well as the nature sounds plus foot sole reflexology massage group (P = .001). Single or combined interventions can increase the level of consciousness in comatose patients and reduce the duration of coma.

Comparison of the effects of inhalation aromatherapy using Damask Rose aroma and the Benson relaxation technique in burn patients: A randomized clinical trial.

BACKGROUND: Burn injuries are often accompanied by painful and distressing consequences, which can lead to long-term psychological issues. The most common form of anxiety in burn patients is pain anxiety. It is described as the feeling of fear and pain prediction caused by painful procedures. AIM: To compare the effects of inhalation aromatherapy using damask rose aroma and the Benson relaxation technique on pain anxiety in burn patients. METHODS: This randomized clinical trial was conducted on 132 patients hospitalized in Motahari Burn Hospital from October 2017 to March 2018. The subjects were selected using a sequential sampling method. Next, they were randomly allocated by the Permuted block randomization method into four groups of rose aroma (5 drops of 40% rose aroma), the Benson relaxation technique, combined rose aroma-Benson relaxation and control. The interventions were performed for three consecutive days and once a day for 20 min, and each session lasted from 45 to 30 min before the daily dressing change. Data was collected using the Persian version of burn specific pain anxiety scale (BSPAS). Data was analyzed using descriptive and inferential statistics via the SPSS software version 16. RESULTS: Immediately after the intervention, on the first, second and third days, significant differences in pain anxiety among four groups were reported. On the first day, the Scheffé ad hoc test indicated statistically significant differences in pain anxiety between all groups (p < 0.001), except rose aroma-plus-Benson relaxation and rose aroma groups (p = 0.15). On the second and third days, there were significant differences between the groups in pain anxiety (p < 0.001). Furthermore, after wound dressing, on the first, second and third days, statistically significant differences in pain anxiety among four groups were reported. On the first day, the Scheffé ad hoc test revealed statistically significant differences in pain anxiety between all groups (p < 0.001). On the second and third days, there were statistically significant differences in pain anxiety between the groups (p < 0.001), except the rose aroma and Benson relaxation groups. Immediately after the intervention, the maximum effect size was on the first day in the group of rose aroma-plus-Benson relaxation and the lowest effect size was on the first day in the Benson relaxation group. However, after wound dressing, the maximum effect size was on the third day in the rose aroma-pus-Benson relaxation group and the lowest effect size was on the first day in the Benson relaxation group. CONCLUSION: The combination of the rose aroma and Benson relaxation has a synergistic effect and has more effects in the reduction of pain anxiety in burn patients than a single intervention. Health care providers can provide these interventions simultaneously and help reduce pain anxiety in burn patients before conducting painful interventions.

Comparison of the effects of nature sounds and reflexology on hemodynamic indices among traumatic comatose patients: A randomized controlled clinical trial.

Background Traumatic comatose patients may experience disturbances in hemodynamic indices due to the nature of their disorder. This study aimed to compare the effects of nature sounds and reflexology on hemodynamic indices in traumatic comatose patients. Methods This randomized clinical trial using a factorial design was conducted on 120 traumatic comatose patients in two teaching hospitals in two urban areas of Iran. The patients were selected using a sequential sampling method and assigned into randomized quadruple blocks as control, nature sounds, reflexology and nature sounds-reflexology (combined) groups. The interventions were performed twice daily in two consecutive days lasting 30 min each time. The hemodynamic indices were measured before, and immediately, 30 min, and 2 h after the intervention using calibrated monitors. Descriptive and inferential statistics, including one-way ANOVA, Scheffe ad hoc, repeated measure ANOVA, Bonferroni ad hoc Chi-square test and Fisher's exact tests were used for data analysis via the SPSS software V.16. Results Significant differences were reported in terms of the mean arterial pressure between the control and reflexology groups (p=0.002), and the combined group (p=0.008) immediately after the interventions. The combined group showed statistically differences in systolic blood pressure compared to the nature sounds (p=0.007) and control (p=0.015) groups 30 min after the interventions. The nature sounds group showed differences in the pulse rate from the reflexology (p=0.048) and control (p=0.015) groups 30 min after the interventions in the second day. Conclusions While the immediate effects of the interventions on induction of the feeling of relaxation and tranquility, and reduction of hemodynamic indices were reported, they diminished over time. Nature sounds and reflexology as low-cost and relaxing tranquilizing methods can be used for the reduction of tension and improvement of hemodynamic indices among traumatic comatose patients.

Comparing the effect of patients preferred music and Swedish massage on anticipatory anxiety in patients with burn injury: Randomized controlled clinical trial.

BACKGROUND: Effective strategies should be considered for reducing pain and anxiety and improving burn patients' well-being. This study was aimed to compare the effect of preferred music and Swedish massage on pain anticipatory anxiety in burn patients. METHODS: In this randomized controlled clinical trial 240 hospitalized burn patients were selected and assigned to Swedish massage, preferred music, combination of Swedish massage and preferred music and control groups through fixed blocking randomization. Interventions was offered before wound care one time for 20 min on patients' bedside. Patients in the control group only received routine care. The Persian version of Burn Specific Pain Anxiety Scale were used for data gathering. Data was analyzed using SPSS-PC (V.16.0). RESULTS: There was a statistically significant difference between groups regarding mean changes of anticipatory anxiety (P < 0.001). The results indicated that patients in the group of combination of both interventions reported significantly lower anticipatory anxiety as compared to the preferred music (P = 0.015), Swedish massage (P = 0.002) and control (P < 0.001) groups. The mean changes of anticipatory anxiety score in the Swedish massage and preferred music groups had a statistically significant difference with the control group (P < 0.001). There was no difference between the mean changes of anticipatory anxiety in preferred music and Swedish massage groups. CONCLUSIONS: According to the results, combining both Swedish massage and preferred music was more effective in reducing anticipatory anxiety in burn patients. Health care providers, particularly, nurses can provide these two noninvasive and economical interventions simultaneously and benefits the synergistic effect of them in burn patients.

Comparison of the Effects of Benson Muscle Relaxation and Nature Sounds on the Fatigue in Patients With Heart Failure: A Randomized Controlled Clinical Trial.

This study was conducted with the aim of comparing the effects of Benson muscle relaxation and nature sounds on fatigue in patients with heart failure. Fatigue and exercise intolerance as prevalent symptoms experienced by patients with heart failure can cause the loss of independence in the activities of daily living. It can also damage self-care and increase dependence to others, which subsequently can reduce the quality of life. This randomized controlled clinical trial was conducted in an urban area of Iran in 2016. Samples were consisted of 105 hospitalized patients with heart failure chosen using a convenience sampling method. They were assigned to relaxation, nature sounds, and control groups using a randomized block design. In addition to routine care, the Benson muscle relaxation and nature sounds groups received interventions in mornings and evenings twice a day for 20 minutes within 3 consecutive days. A 9-item questionnaire was used to collect data regarding fatigue before and after the interventions. Relaxation and nature sounds reduced fatigue in patients with heart failure in comparison to the control group. However, no statistically significant difference was observed between the interventions. Benson muscle relaxation and nature sounds are alternative methods for the reduction of fatigue in patients with heart failure. They are inexpensive and easy to be administered and upon patients' preferences can be used by nurses along with routine nursing interventions.

Effect of Multimedia Self-Care Education on Quality of Life in Burn Patients.

BACKGROUND: Burn injuries can have adverse effects on quality of life of patients and can disturb their physiological, psychological, social and spiritual well-being. This study aimed to investigate the effect of multimedia self-care program on quality of life in burn patients. METHODS: This Randomized controlled clinical trial was conducted from November 2015 to December 2016. The samples were hospitalized burn patients with 10% to 45% of 1st, 2nd and 3rd degree burns of total body surface area (TBSA). The patients were randomly allocated into experimental (n=50) and control (n=50) groups. Both groups received the routine in-person self-care trainings of the hospital and then the experimental group received self-care compact disks. The quality of life questionnaire in both groups were completed before intervention and after 3-months and statistically analyzed. RESULTS: Accordingly, the changes in quality of life and the dimensions between both groups after 3 month of intervention were significant. The changes in quality of life in experiment group was significantly greater than control group for physical, psychological and social variables. CONCLUSION: According to the findings, using multimedia self-care programs can improve burn patient's quality of life, so it is recommended for nurses and hospital staffs of burn injury wards to use multimedia self-care programs as a complementary therapy measure.

The effect of shiatsu massage on pain reduction in burn patients.

BACKGROUND: Burn is a tragedy that follows multiple problems in a patient including pain, anxiety and lack of confidence into medical team. This study evaluated the effect of shiatsu massage on pain intensity of burn patients. METHODS: A total of 120 burn patients from Motahhari Burn Hospital and of both genders were randomly divided into 4 groups of undergoing hand massage, leg massage, both hand and leg massages, and the control group. The effect of shiatsu massage in pain relief of burned patients was evaluated. The visual analog scale (VAS) was used to assess pain in burn patients. RESULTS: Pain intensity in the control group before and after the intervention was not statistically significant (p=1). In all massage groups, the difference for pain intensity before and after the intervention was statistically significant. CONCLUSION: According to our data, shiatsu method over both hands and legs were effective in pain reduction and can be recommended together with analgesics to decrease the dose.