The Effect of Emotional Freedom Technique on Fatigue among Women with Multiple Sclerosis: A Randomized Controlled Trial.

BACKGROUND: This study aimed to investigate the effect of Emotional Freedom Technique (EFT) on the severity of fatigue among women with Multiple Sclerosis (MS). MATERIALS AND METHODS: This was a single-blind, randomized controlled trial study conducted on 50 women with MS in Isfahan, Iran. Sampling was performed using simple sampling method, then the participants were randomly divided into two groups of case and sham using the minimization method. The EFT intervention was performed on the case group, 2 sessions per week for a 4-weeks period. In the sham group, with the same psychological part of the EFT technique like case group, mild tapping was applied on false points for the same period of time. Fatigue severity score was obtained using the Fatigue Severity Scale (FSS) before and immediately and 4 weeks after the intervention in the two groups. Data analysis was conducted using descriptive and inferential statistical methods. RESULTS: The results of the independent t-test indicated that the mean (SD) score of fatigue severity before the intervention was not significantly different between the case and sham groups 5.48 (0.75) and (5.39 (0.71) with (p = 0.67). However, this difference was significant immediately [(3.05 (0.89) and 5.15 (0.94)] and 4 weeks after the intervention 3.10 (0.81) and 5.59 (0.57) (p < 0.001). CONCLUSIONS: It seems that EFT is effective in diminishing fatigue among patients with MS and is recommended as a convenient and safe non-medicament strategy for self-management of fatigue among these patients, and can be used at the bedside by nurses.

Effects of blended aromatherapy using lavender and damask rose oils on the test anxiety of nursing students.

BACKGROUND: People experience extreme anxiety in testing situations, so it considers as a psychological condition and can actually impair learning and hurt test performance. People experience some degree of stress and anxiety before and during examinations. This study aimed to investigate the effect of blended aromatherapy using lavender and damask rose oils on the test anxiety of nursing students. MATERIALS AND METHODS: The present study was a single-blinded clinical trial study. Seventy nursing students were selected and randomly assigned to two experimental and sham groups. For the experimental group, seven droplets of lavender, 10%, and three droplets of damask rose oil, 10%, and for the sham group, ten droplets of sesame oil were poured on a nonabsorbent pad which was placed within a 20-cm distance from the students' noses on their chairs' handles. The data were collected by using a two-part questionnaire including demographic information and State-Trait Anxiety Inventory 1, before, 15 min after the intervention, and immediately at the end of the test. Data were analyzed using descriptive (frequency, mean, and standard deviation) and inferential (independent t-test, ANOVA with repeated measure, Fisher's exact test, and least significant difference post hoc test) statistics. RESULTS: It was found that no significant difference between the two groups in terms of age, the number of credits, Semester Grade Point Average and, gender, place of residence and marital status and the two groups were almost identical in regard of the above variables (P > 0.05). State anxiety mean scores of the experimental group were lower than the mean scores of the sham group, 15 min after the intervention and at the end of the test, and the difference between the groups was statistically significant (P < 0.05). CONCLUSIONS: Blended aromatherapy is effective in improving the test anxiety of nursing students. Therefore, it can be used as a therapeutic approach to reduce test anxiety.

The effect of acupressure on quality of life among female nurses with chronic back pain.

BACKGROUND: Chronic back pain is one of the most common work-related diseases and most important of musculoskeletal disorders in nursing professionals and because of the physical and psychological effects, has a significant impact on quality of life (QOL). Acupressure is a holistic form of complementary medicine. This study aimed to investigate the effect of acupressure on QOL among female nurses with chronic back pain. MATERIALS AND METHODS: This randomized single-blind clinical trial was conducted on 50 nurses with chronic back pain working at the selected hospitals in Isfahan, Iran. After convenient sampling, the subjects were randomly allocated, through lottery, to the two groups of experimental (n = 25) and sham (n = 25). In the experimental group, acupressure techniques were performed during 9 sessions, 3 times a week for 14 min for each patient. In the sham group, points within 1 cm of the main points were only touched. Data were collected using the SF36 questioner, before, and immediately, 2 weeks, and 4 weeks after the intervention. Data analysis was performed using SPSS software. RESULTS: Independent t-test showed that the mean total score of QOL before the intervention was not significantly different between the two groups before the intervention (P = .68). However, it was significantly higher in the experimental group compared to the Sham group, immediately, 2 weeks, and 1 month after the intervention (P < .001). CONCLUSIONS: Acupressure on specific points of the foot and back improves back pain and as a result, increases QOL. Therefore, acupressure can be used as a drug-free and low-cost approach without side effects to improve QOL in nurses with chronic back pain.

A comparison the effects of reflexology and relaxation on the psychological symptoms in women with multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) occurs with a variety of physical and psychological symptoms, yet there is not a conclusive cure for this disease. Complementary medicine is a current treatment which seems is effective in relieving symptoms of patients with MS. Therefore, this study is aimed to determine and compare the effects of reflexology and relaxation on anxiety, stress, and depression in women with MS. SUBJECTS AND METHODS: This study is a randomized clinical trial that is done on 75 women with MS referred to MS Clinic of Kashani Hospital. After simple non random sampling, participants were randomly assigned by minimization method to three groups: reflexology, relaxation and control (25 patients in each group). In the experimental groups were performed reflexology and relaxation interventions within 4 weeks, twice a week for 40 min and the control group were received only routine treatment as directed by a doctor. Data were collected through depression anxiety and stress scale questionnaire, before, immediately after and 2 months after interventions in all three groups. Chi-square, Kruskal-Wallis, repeated measures analysis of variance and one-way analysis of variance and least significant difference post hoc test via SPSS version 18 were used to analyze the data (P < 0.05) was considered as significant level. RESULTS: The results showed a significant reduction in the severity of anxiety, stress and depression during the different times in the reflexology and relaxation groups as compared with the control group (P < 0.05). CONCLUSION: The results showed that reflexology and relaxation in relieving anxiety, stress and depression are effective in women with MS. Hence, these two methods, as effective techniques, can be recommended.

The effect of reflexology on pain perception aspects in nurses with chronic low back pain in Isfahan.

BACKGROUND: The most important part in experiencing and recognizing the threshold of pain is the perception of pain. Reflexology is a kind of complementary therapy which is rooted in the beliefs of the community. This study was aimed to determine the effect of reflexology on pain perception aspects in patients with chronic low back pain. MATERIALS AND METHODS: This single-blind clinical trial study was performed on 50 nurses with chronic low back pain, who were selected by convenient sampling and then randomly divided into the case and the control groups. Reflexology was conducted for 2 weeks in both groups as three 40-min sessions per week. Perception aspects of pain were measured using the McGill pain perceptual dimension scale score. Data analysis was performed using SPSS. RESULTS: The overall mean scores of perceptual aspects of pain after the intervention in the case and the control groups were 20 ± 5.97 and 29.60 ± 7.38, respectively, and independent t-test showed a statistically significant difference between the two groups (P < 0.001). Comparing the results in the cognitive aspects of pain separately showed a significant difference between the two groups in the aspects of sensory, pain assessment, and diversity before and after the intervention (P < 0.001), but the difference in the emotional aspect was not significant. CONCLUSIONS: Reflexology, which can be done by nurses, has the ability to reduce the intensity score and cognitive aspects of pain. Therefore, it is proposed to be included in patients' surveillance.

A comparison of the effects of reflexology and relaxation on pain in women with multiple sclerosis.

BACKGROUND: Pain is a common and significant symptom in many individuals with multiple sclerosis (MS). The presence and severity of pain in individuals with MS has also been shown to be associated with higher levels of depression, functional impairment, and fatigue. It is common for MS patients and their caregivers to worry about narcotic addiction in the management of chronic pain. Therefore, this study aimed to determine and compare the effects of reflexology and relaxation on pain in women suffering from MS. METHODS: This study was a single-blind randomized clinical trial performed on 75 patients with MS referred to the MS Clinic of Ayatollah Kashani Hospital (Isfahan, Iran). After simple non-random sampling, using the minimization method, participants were randomly assigned to the three groups of reflexology, relaxation, and control. In the experimental groups, foot reflexology and relaxation interventions (Jacobson and Benson) were performed within 4 weeks, twice a week for 40 min. The control group received routine care and medical treatment as directed by a doctor. Data were collected using the Numerical Rating Scale before, immediately after, and 2 months after interventions in all three groups. Data analysis was performed using SPSS version 18 and descriptive and inferential statistical tests. RESULTS: Findings obtained from analysis of variance (ANOVA) showed no significant differences between mean pain intensity scores in the three groups preintervention and 2 months after interventions (p > 0.05). However, this difference was statistically significant immediately after the study (p < 0.05). Findings obtained from repeated measures ANOVA showed that the severity of pain significantly differed during different times in reflexology and relaxation (p < 0.05); however, this difference was not significant in the control group (p > 0.05). Furthermore, Fisher's least significant difference (LSD) revealed a significantly higher reduction in pain intensity scores in the reflexology group after the intervention, compared with the two other groups, but showed no significant differences between relaxation and control groups. There were no significant differences between the three groups 2 months after the interventions (p > 0.05). CONCLUSIONS: The results showed that both interventions are effective on relieving pain in women with MS; however, it appears that the effect of reflexology on pain reduction is greater than that of relaxation. Hence, these two methods can be recommended as effective techniques.

Comparing the effects of reflexology and relaxation on fatigue in women with multiple sclerosis.

BACKGROUND: Fatigue is the most common and highly disabling symptom of multiple sclerosis (MS) that has negative effects on employment, the process of socialization, compliance with the disease, and other factors effective on activities of daily living. The usage of complementary and alternative medicine methods in MS patients is higher than in the general population. However, there is no scientific evidence to support their effectiveness. Therefore, this study aimed to compare the effects of reflexology and relaxation on fatigue in women with MS. MATERIALS AND METHODS: This study is a single-blinded randomized clinical trial that was done on 75 patients with MS who referred to the MS Clinic of Ayatollah Kashani Hospital (Isfahan, Iran). After simple non-random sampling, participants were randomly assigned by minimization method to three groups: Reflexology, relaxation, and control groups (25 patients in each group). In the experimental groups, the interventions foot reflexology and relaxation (Jacobson and Benson) were performed for 4 weeks, twice a week for 40 min in each session, and the control group received care and routine medical treatment as directed by a physician. Data were collected through a questionnaire and the fatigue severity scale before, immediately after, and 2 months after interventions from all three groups. Data analysis was performed by SPSS version 18 using descriptive and inferential statistical methods. RESULTS: Findings obtained from analysis of variance (ANOVA) showed that there was no significant difference in the mean fatigue severity scores in the pre-interventions between the three groups (P > 0.05), but there was significant difference immediately after and 2 months after interventions between the three groups (P < 0.05). Findings obtained from repeated measures (ANOVA) showed that there was significant difference in the mean fatigue severity scores during different times between the three groups (P < 0.05), while this difference was not significant in the control group (P > 0.05). Furthermore, least significant difference post-hoc test revealed that the mean scores of fatigue severity immediately after intervention was lower in the reflexology group than in the other two groups and were lower in the relaxation group than in the control group; 2 months after interventions, the mean scores of fatigue severity were lower in the reflexology group than in the other two groups, but there was no significant difference between the two groups of relaxation and control (P > 0.05). CONCLUSIONS: It seems that both interventions were effective in reducing fatigue, but the effects of reflexology on reducing fatigue were more than those of relaxation. Hence, as these two methods are effective and affordable techniques, they can be recommended.

The effects of reflexology on chronic low back pain intensity in nurses employed in hospitals affiliated with Isfahan University of Medical Sciences.

BACKGROUND: Humans have been involved with the phenomena of pain and pain relief from the ancient times. Back pain is the most common pain. In fact, eight out of ten people experience it in their lifetime. However, individuals with specific jobs, including nurses, are faced with this problem more. Nursing is in the top ten careers suffering from the most severe musculoskeletal injuries. There are non-pharmacologic and pharmacologic treatments to relieve back pain. One of the non-medical treatments of pain is called reflexology which is a branch of complementary and alternative therapies. This research has been conducted to investigate the effect of reflexology on chronic low back pain intensity. MATERIALS AND METHODS: This study was a double-blind clinical trial. The study population consisted of 50 female and male nurses suffering from chronic low back pain working in hospitals affiliated with Isfahan University of Medical Sciences. The participants were divided into two groups of reflexology and non-specific massage. A questionnaire was completed through interviews and a 40 minute sessions of interventions were performed three times a week for two weeks. Pain intensity was measured by Numerical Analogue Scale for pain before and after the intervention. Descriptive and inferential statistics, including independent t-test and chi-square test, were used to analyze the data. FINDINGS: The results showed a significantly higher reduction in pain intensity scores in the reflexology group after the intervention as compared with the non-specific massage group. However, the non-specific massage was also significantly effective in reducing pain. CONCLUSIONS: Reflexology can be effective in reducing the severity of chronic back pain, i.e. it is able to reduce pain from moderate to mild. Thus, this technique is recommended to be performed by nurses as a complementary therapy in patient care.

Effect of aromatherapy on the quality of sleep in ischemic heart disease patients hospitalized in intensive care units of heart hospitals of the Isfahan University of Medical Sciences.

BACKGROUND: Sleep disorder is one of the common problems patients face in ICU and CCU and it is usually treated by sleeping pills. Nowadays, the complementary medicine is highly considered because of its effectiveness and safety. Aromatherapy is one of the holistic nursing cares which sees human beings as a biological, mental and social unit while the psychological dimension has the central role. Each of these dimensions is dependent on each other and is affected by each other. Therefore, it is fundamental for nurses to provide aromatherapy in their clinical performance. Aromatherapy helps treatment of diseases by using vegetable oils and it seems to be effective in reducing sleeplessness. METHODS: This was a clinical trial on 64 patients (male and female) hospitalized in CCU in Al-zahra and Chamran hospitals. The intervention included 3 nights, each time 9 hours aromatherapy with lavender oil for the experiment group, while the controls received no intervention. Both groups filled out the SMHSQ that includes 11 items to assess sleep quality before and after intervention. RESULTS: Data analysis showed that the mean scores of sleep quality in the two groups of experiment and control were significantly different after the aromatherapy with lavender oil (p < 0.001). CONCLUSIONS: Quality of sleep in ischemic heart disease patients was significantly improved after aromatherapy with lavender oil. Therefore, using aromatherapy can improve the quality of their sleep and health.

Multivariate optimisation of microwave-assisted extraction of capsaicin from Capsicum frutescens L. and quantitative analysis by 1H-NMR.

A simple and rapid microwave-assisted extraction (MAE) procedure combined with 1H-NMR spectrometry was developed and optimised for the extraction and quantitative determination of capsaicin in Capsicum frutescens. The influence of experimental variables, including irradiation power, extraction temperature and dynamic extraction time before reaching the selected extraction temperature, on the performance of the extraction procedure was systematically studied using a Box-Behnken experimental design followed by a conventional central composite design approach. Statistical treatment of the results together with results from some additional experiments suggested optimum extraction conditions as 120 degrees C and 150 W, for 15 min with acetone as extractant. The optimised MAE method provides extracts that can be analysed quantitatively using 1H-NMR without any preliminary clean-up or derivatisation steps. In the 1H-NMR spectrum of the crude extracts the doublet signal in the delta range 4.349-4.360 ppm was well separated from other resonances in deuterated chloroform. The quantity of the compound was calculated from the relative ratio of the integral value of the target peak to that of a known amount of dimethylformamide as internal standard. In comparison with traditional Soxhlet extraction, the proposed method is less labour-intensive and provides a drastic reduction of extraction time and solvent consumption. In addition, MAE showed higher extraction yield and selectivity, with comparable reproducibility and recovery, relative to both conventional Soxhlet and sonication methods.