Evaluating the Effect of Preoperative Provision of Information on Salivary Cortisol in Patients Undergoing Breast Cancer Surgery: A Randomized Controlled Study.

PURPOSE: Surgery is considered to be an anxious experience and most patients experience preoperative anxiety. Preoperative awareness has long been one of the most effective ways to reduce fear and anxiety caused by surgery. The aim of this study was to determine the effect of preoperative provision of information on salivary cortisol in candidates for breast cancer surgery. DESIGN: This randomized clinical trial was conducted on 80 patients (divided into control group and intervention group; 40 patients in each group) admitted to the surgery department of the Cancer Institute of Imam Khomeini hospital in Iran. Samples were selected using random allocation method with a block size of four. Data were collected on participants' demographic characteristics and salivary cortisol. METHODS: The educational intervention for patients in the control group was routine training and for patients in the intervention group was based on the training booklet approved by cancer specialists. Findings were analyzed using SPSS software version 21. FINDINGS: The mean age of participants in the intervention and control groups was 44.00 ± 11.45 and 42.62 ± 12.83 years, respectively . The mean score of anxiety in the intervention group was 18.85± 6.19 before intervention, and decreased to 7.40± 3.68 after intervention . The mean score of anxiety in the control group was 19.75 ± 7.26 and significantly decreased to 14.25 ± 5.73 at the end of the study. CONCLUSIONS: The results showed that preoperative anxiety significantly decreased in both groups, but was lower overall in the intervention group. In fact, using an educational booklet to raise awareness about patients' health, surgery knowledge and postoperative care as well as how to adapt to postsurgery physical changes and to promote psychological support can reduce patients' anxiety. Hence, providing education to patients may be integrated as a complementary method in patients' routine education.

A Heideggerian Phenomenological Study of the Lived Experiences of Ghanaian Patients Living With End-Stage Renal Disease.

There is a lack of knowledge regarding perceptions, feelings, and experiences of Ghanaian patients living with ESRD. This study aimed to discover the experience and meaning of living with ESRD. This qualitative study was conducted using Heideggerian hermeneutic phenomenology. A total of 13 participants were purposefully selected, and data was collected through individual semi-structured interviews. The recorded interviews were transcribed and analyzed using Diekelmann, Allen, and Tanner method. After the final analysis, five main themes emerged: Spiritual fluctuation, Living in uncertainty, Period of agony and frustration, Tough fortification, and Changed roles and status. This study provided deep insight and understanding regarding the lived experiences of patients living with end-stage renal disease in Ghana. The results of this study may benefit nursing care in terms of considering the patients' lived experiences to provide quality and person-centered care.

A comprehensive review of histopathological findings of infections induced by COVID-19.

The severe acute respiratory syndrome (SARS)-Coronavirus (CoV2) virus, first identified in Wuhan, China, caused the coronavirus disease 2019 (COVID-19) which soon became a global pandemic, as labelled by the World Health Organization (WHO). The transmission method of the infection is primarily through droplets of various sizes. The SARS-CoV2 virus leads to a severe respiratory illness which in the first place causes the simulation of the acute respiratory syndrome. In order to diagnose of COVID-19 efficiently, samples with infection probability need to be examined through histopathological methods. Survival chances of the infected can remarkably increase if the virus is diagnosed timely by reverse transcription-polymerase chain reaction (RT-PCR) or computed tomography (CT) scan of the chest. One of the destructive effects of COVID-19 is the formation of ground-glass opacity (GGO) in the lungs which might be regarded to be equivalent to high-altitude pulmonary edema (HAPE). COVID-19 acts very similarly to SARS and Middle East Respiratory Syndrome (MERS) which can be inactivated by the chemical compounds of ethanol and sodium hypochlorite. Epidemiologic characteristics of COVID-19 have been indicated by numerous studies; however, there is still a lack of details of pathologic changes in the lung. The present comprehensive review is an attempt to assess and cover the current state of knowledge on COVID-19 disease based on the histopathologic studies conducted before May 2020.

The impact of empowerment model-based education on quality of life of transgender people under hormone therapy: A randomized clinical trial.

INTRODUCTION: Gender identity disorder is a complex psychological problem and people with this disorder are at risk of many problems, including reduced quality of life. Empowerment intervention is one of the methods that can be used to improve the quality of life of people. The present study aimed to investigate the effect of empowerment model-based training on the quality of life of transgender people undergoing hormone therapy. METHODS: The present study is a randomized clinical trial that was conducted in 2012 on 81 transgender people at Tehran Welfare Center. The study samples were randomly assigned into two groups of intervention and control. The intervention group received training based on the empowerment model (threat perception, problem-solving, educational participation, and evaluation) and the control group received routine treatment. RESULTS: According to the findings, after the intervention, a statistically significant difference was found between the two groups in terms of the mean level of overt anxiety (P = 0.045) and aspects of emotional health (P = 0.030), the general perception of health (P = 0.007), mental health (P = 0.008), and overall quality of life (P = 0.005). Also, although there was a statistically significant difference in the aspect emotional well-being in the intervention group before and after the intervention (P = 0.034), this difference was not significant between the two groups (P = 0.274). CONCLUSION: The results showed that the empowerment-based training program had a significant relationship with the improvement in aspects of emotional health, the overall perception of health, mental health, emotional well-being and overall quality of life.

The Effect of Lavender Aroma on Anxiety of Patients Having Bone Marrow Biopsy.

INTRODUCTION: Bone marrow biopsy is a common procedure for the diagnosis and treatment of hematologic diseases and tumors, which are associated with anxiety. The purpose of this study was to examine the effect of lavender aroma on anxiety of patients having bone marrow biopsy. MATERIALS AND METHODS: This study was performed on 80 patients referred to Vali-e-Asr Hospital for bone marrow biopsy. Samples were selected by convenience method and were assigned into intervention and control groups using randomized blocks of 4. Random sequence was generated by RAS software. Several drops of distilled water on a cotton ball was used in the control group and same amount of lavender essential oil on a cotton ball was used in the intervention group. Then, participants in both groups were asked to smell the cotton ball for 15 minutes and then, their anxiety level was measured immediately. The results were analyzed by SPSS software version 25 using covariance analysis and rank regression. RESULTS: The results showed that, the mean scores of anxiety in the control and intervention groups were 6.3 ± 1.92 and 3.75 ± 1.05, respectively. There was a significant difference (p <0.05) between the two groups in terms of anxiety score.The results showed that there was a significant difference in anxiety score between two groups in terms of variables such as age, gender, physician experience, biopsy history and biopsy site (P <0.05). The results also showed no significant difference between the (p >0.05). CONCLUSION: The results of this study showed that bone marrow biopsy is associated with anxiety, and smelling of lavender aroma is effective in reducing anxiety in patients undergoing this procedure. This fragrance can be used by treatment team in hematology and oncology clinics to reduce anxiety caused by bone marrow biopsy.
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