Effect of Lavender Aromatherapy on Anxiety and Fatigue in Hemodialysis Patients: A Systematic Review and Meta-Analysis.

Background: Several studies have evaluated the effects of lavender essential oil on the anxiety of hemodialysis (HD) patients, but most of them did not estimate the pooled effect size. The current systematic review and meta-analysis was conducted to evaluate the effects of lavender on anxiety and fatigue among HD patients. Methods: Eligible studies were selected based on the PRISMA steps and protocol. Literature was retrieved from PubMed, Web of Science, Scopus databases, Cochrane, ClinicalTrials.gov, and Google Scholar Search Engines until Sep 2022. The risk of bias and analysis were evaluated using version 2 of the Cochrane risk-of-bias tool and STATA v.14 software, respectively. Effect sizes were pooled using random effect models. Results: Nine studies were included. Lavender oil significantly reduced the average anxiety of HD patients compared to the control group (SMD: -2.51, 95% CI: [-3.56, -1.45], Z=4.67, P<0.001, I2 :89.9%). Also, it significantly reduced the average fatigue compared to the control group (SMD: -1.56, 95% CI: [-2.49, -0.63], Z=3.29, P=0.001, I2:92.2%). Subgroup analysis indicated controversial results regarding session frequency and drop number of lavender oil. Conclusion: Using Lavender oil significantly reduced fatigue and anxiety in HD patients.

The efficacy of technology-based devices on the first-attempt success rate for difficult intravenous access in pediatrics: A systematic review and network meta-analysis.

INTRODUCTION: Previous studies have compared various technology-based devices, such as ultrasonography (USG), near-infrared (NIR), and transilluminator (TI), with standard care (SC) to facilitate peripheral intravenous cannulation (PIVC) in pediatric patients. This study aims to investigate the efficacy of these interventions on the first-attempt success rate (FASR) of PIVC in pediatric patients with difficult intravenous access (DIVA) using network meta-analysis (NMA). METHODS: We conducted a comprehensive literature search in databases to identify randomized clinical trials comparing the effects of different devices on the FASR of PIVC from inception until August 2023. Pooled relative risks with 95% credible intervals were estimated using pairwise and network meta-analysis with random effects. To rank the efficacy of devices, we calculated the probabilities of the surface under the cumulative ranking curve (SUCRA). RESULTS: A total of 18 studies were included in the final analysis. The results of pairwise meta-analysis showed that the use of devices increased the FASR for PIVC by 13% (RR: 1.13, 95% CI: [0.98, 1.30]) compared to SC. The ranking of interventions based on efficacy from highest to lowest was as follows: USG (SUCRA: 1), NIR (SUCRA: 0.6), SC (SUCRA: 0.3), and TI (SUCRA: 0.1), with a very low confidence estimate. CONCLUSION: Based on our findings, the prioritization of device usage to increase the FASR of PIVC in pediatric patients with DIVA is as follows: USG, NIR, SC, and TI, respectively. However, due to inconsistencies in the network, existence of an overall high risk of bias in the included studies, and very low confidence estimate, further clinical trials are required.

The challenges of nursing care for patients with lumbar discectomy: A qualitative study.

AIM: Patients with lumbar disc surgery experience many different problems during their hospital stay. Nurses also face different challenges in providing care to them. Nonetheless, no study has yet specifically addressed these challenges to the best of our knowledge. This study aimed at exploring the challenges of nursing care for patients with lumbar discectomy. DESIGN: This qualitative study was conducted in 2022 using content analysis. METHODS: Eight nurses, three patients with lumbar discectomy, and one physician were purposively selected from the neurosurgery wards of the hospitals affiliated to Golestan University of Medical Sciences, Gorgan, Iran. Semi-structured interviews were conducted for data analysis and the content analysis method recommended by Elo and Kyngas was used for data analysis. The main phases of this method are open coding, grouping, categorization, and abstraction. The MAXQDA 10 software was employed to facilitate data management. Data collection continued to reach data saturation. RESULTS: The challenges of nursing care for patients with lumbar discectomy were categorized into eleven subcategories and three main categories, namely dominant routine-based practice in the healthcare system, futile attempt for team-based care, and shortages as a major barrier to quality care. There are different personal, professional, financial, structural, and organizational challenges in nursing care for patients with lumbar discectomy which can negatively affect postoperative patient recovery.

Effect of Pre-dialysis Serum Sodium Measurement on Reduction of Hemodialysis Complications.

INTRODUCTION: Despite great advances in hemodialysis, complications during dialysis remain in force. Accurate assessment of dry weight is a determining factor in the prevention of hemodialysis complications. This study is designed to evaluate the effect of adjustment of ultrafiltration rate, on hemodialysis complications, based on dry weight calculation, by measuring the pre-dialysis serum sodium. METHODS: In this single-blind clinical trial 50 patients were included. The patients were randomly divided into case and control groups. First, in the intervention group, the blood sodium level was measured before dialysis. Then, the dry weight of the patients was determined, ultrafiltration was adjusted according to the dry weight, and the patients' dialysis program was performed. In the control group, dry weight was determined routinely. Blood pressure, muscle cramps, nausea, and vomiting were recorded in both groups for 3 months. RESULTS: The results showed a significant difference between the two groups in the rate of postoperative nausea and vomiting (P < .05) and muscle cramps during dialysis (P < .05). There were no significant differences between the two groups in blood pressure drop during dialysis and fatigue after hemodialysis in the first, second, and third months (P > .05). CONCLUSION: Accurate assessment of dry weight by the pre-dialysis blood sodium formula, reduces muscle cramps, nausea, and, vomiting.  DOI: 10.52547/ijkd.7170.

Facilitators and barriers to return to work in patients after heart surgery.

BACKGROUND: Recognition of the factors influencing returning to work by people after heart surgery is very significant in performing supportive interventions. Factors affecting return to work of Iranian patients after surgery are unknown. Therefore, a qualitative study is in demand in order to close this knowledge gap. This study was aimed to explore the facilitators and barriers of return to work after heart surgery. MATERIALS AND METHODS: This qualitative study was conducted during 2020-2021. People after heart surgery were studied in this research. Nineteen interviews were performed with 17 participants. The main participants were selected from the cardiac surgery ward of Golestan Province Hospital. The sampling method was purposeful. Data were collected through semi-structured interviews. Questions were asked in an unguided and open-ended manner. Data analysis was performed by qualitative content analysis. RESULTS: According to the results, "perceived psychosocial support," "individual characteristics," and "occupational factors" were considered as facilitators and "effects of heart surgery" and "limited support of public and private institutions" were introduced as barriers to return to work in patients after heart surgery. CONCLUSIONS: The effects caused by heart surgery and limited support of public and private institutions were identified as barriers to return to work. Cardiac rehabilitation after surgery can reduce the impact of heart surgery and can help people to return to work. It is recommended that the planners of the Ministry of Labor and Social Welfare and Health, with the support of insurance organizations, help solve the work problems of people after heart surgery.

Maintaining professional integrity in Iranian nurses.

Aim To determine obstacles in maintaining professional integrity of nurses and their strategy to overcome them. Methods A conventional content analysis was conducted by 16 interviews. The data collection instruments were semi-structured interviews, observation and field notes. The interviews were recorded and transcribed verbatim, then analysed by Grandhime and Landman approach. For the validity and reliability of the study Guba and Lincoln criteria were used. Results Latent meanings were formulated into "passive management", "inefficient organization", and "solid spirituality" themes. Passive management consisted of "lack of support from managers", "not understanding the nurses" and "improper supervision system". Inefficient organization was composed of "nursing staff shortages", "underestimation of nurses' roles" and "high workload". "Religious beliefs" and "personal beliefs" constituted the "solid spirituality" theme. Conclusion There are factors that decline motivations in Iranian nurses; nevertheless, it is still possible to be a professionally integrated nurse. Among many factors contributing to internalization of professional integrity of nurses, spirituality is one of the most prominent factors.

Nursing managers attitude toward spirituality and spiritual care in Khorasan Razavi Province hospitals in 2016.

BACKGROUND AND AIM: Spiritual care is an important part of nursing practice that seems to provide comprehensive care to patients. Nursing manager's attention to the spiritual dimension is one of the most important aspects affecting human health. Therefore, the aim of this study was to determine nursing managers' attitude to spirituality and spiritual care in hospitals in Khorasan Razavi Province in 2016. METHODS: In this cross-sectional study, 110 management nurses (8 matrons, 37 supervisors and 65 head nurses) of hospitals in Khorasan Razavi Province (2016) were recruited for the study. Data were collected using a Spirituality & Spiritual Care Rating Scale (SSCRS) questionnaire in two parts, demographic information and questions related to the research objectives. Data were collected and analyzed using SPSS 16 software and doing descriptive (frequency, mean, standard deviation) and inferential statistics (independent-samples t-test, ANOVA) and considering levels of significance (p<0.05). RESULTS: The results showed mean and standard deviation in management nursing attitude to spirituality (4.01±0.35) and spiritual care (4.03±0.78). The result showed significant differences between the attitude to spirituality and spiritual care and gender, age and work experience in nursing management (p<0.05). CONCLUSIONS: Management nursing has high level attitude to spirituality and spiritual care. Therefore, providing the perfect platform to provide this care, and for nurses to implement it in hospitals is recommended.

Nutritional care of elderly patients in acute care settings: A qualitative study.

AIM: Poor nutritional status is common in older adult patients. The present study aimed to explore barriers and facilitators to nutritional care of elderly patients in acute care settings. METHODS: Data were collected through individual face-to-face interviews with 12 registered nurses, and analyzed using interpretive description methodology. RESULTS: Two core themes emerged from the analysis of data: (i) neglected care, with three subthemes of "support but also independence," "unsupportive environment" and "responsibility of the family;" and (ii) a humanitarian ethic, with two subthemes of "respect and dignity" and "humanitarian care." CONCLUSIONS: As an integral part of holistic care, elderly patient nutrition should be emphasised in health professional education, and promoted through managerial support, multidisciplinary collaborations, and implementation of appropriate monitoring and evaluation systems.

Family Involvement in the Care of Hospitalized Elderly Patients.

Family participation in caregiving to elderly inpatients is likely to improve the quality of care to older patients. This qualitative design study applied semi-structured interviews to elicit experiences from nurses, families, and patients on the notion of family participation in the care of elderly patients in two general teaching hospitals in Iran. Data were gathered using individual interviews, field notes, and participant observations. Interviews were recorded, transcribed verbatim, and analyzed using manifest and latent content analysis. The following main themes emerged through the data analysis process: (a) safety and quality in patient care and (b) unplanned and unstructured patient care participation. The study concludes that family involvement in caregiving to elderly patients is important, yet the participation should be based upon a planned and structured framework to ensure a safe and satisfying experience for patients, families, and health care team.