Effect of transcutaneous electrical nerve stimulation of acupoints on respiratory outcomes of COVID-19 patients with moderate pulmonary involvement: A parallel randomized clinical trial.

Background and aims: Experiencing respiratory symptoms, especially dyspnea and decreased oxygen saturation (SpO2) level in patients with coronavirus disease 2019 (COVID-19) is associated with increased mortality. The present study was conducted to investigate the effect of transcutaneous electrical nerve stimulation of acupoints (Acu-TENS) on the respiratory outcomes of COVID-19 patients with moderate pulmonary involvement. Methods: In these three-blind parallel randomized clinical trials, 84 patients with COVID-19 admitted to a referral hospital were selected by the convenience sampling method. Participants were randomly assigned to Acu-TENS (n = 42) and control (n = 42) groups. The Acu-TENS group received Acu-TENS over the EX-B1 (Dingchuan) acupuncture point for 45 min for four consecutive days, while participants in the control group received no intervention. Participants' respiratory outcomes, including oxygen saturation, vital signs, and the severity of dyspnea, were evaluated before and after each intervention on four consecutive days. In addition, the need for mechanical ventilation on Days 4, 8, and 12 and the disease's outcome (death or survival) were recorded in SPSS software version 16, and finally, data were analyzed using an independent samples t-test. Results: SpO2, the number of patients without the need for mechanical ventilation, and patient survival after the intervention were significantly higher in the Acu-TENS group compared with the control group (<0.001). However, respiratory rate, heart rate, and the severity of dyspnea after the intervention were not significantly different between the two groups (p > 0.05). Conclusion: The use of Acu-TENS could improve SpO2 as a respiratory outcome of patients with COVID-19 with moderate pulmonary involvement and it can be used as a therapeutic intervention.

Comparing the Effect of Local Application of Peppermint and Cold Compresses on the Severity of Pain from Venipuncture in Dialysis Patients: A Parallel Randomized Clinical Trial Study.

Pain at the injection site is one of the most common complaints in the clinic and is the most important symptom affecting the quality of life of hemodialysis (HD) patients. The aim of this study was to determine the effect and compare the topical application of peppermint and cold compresses on the intensity of pain caused by the insertion of a needle into the fistula of HD patients. In this parallel randomized clinical trial, 99 HD patients were assigned to three groups receiving peppermint, a cold compress, or a control using six blocks. For the peppermint group, 20 min before the needle's insertion, a peppermint gel was used; for the cold compress group, an ice pack was used; and for the control group, the usual method was applied. The patients' pain was assessed with the Visual Analog Scale immediately after the needle's insertion. The results showed that after the intervention, the mean and standard deviation of the pain score in the intervention groups receiving peppermint (4.81 ± 1.13) or a cold compress (4.78 ± 1.13) were significantly less than those of the control group (8.42 ± 1.22) (P <0.001), but there was no statistically significant difference between the peppermint group and the cold compress group (P = 0.91). The use of peppermint, which is a cheap and uncomplicated herbal medicine, and a cold compress, which is easy to use and available, is recommended to reduce the severity of pain caused by venipuncture in HD patients.

Effects of Benson Relaxation Technique and Music Therapy on the Anxiety of Primiparous Women Prior to Cesarean Section: A Randomized Controlled Trial.

Background and Aims: Primiparous women experience high levels of anxiety before cesarean section. Therefore, this research aimed to investigate the effects of the Benson Relaxation Technique (BRT) and Music Therapy (MT) on the anxiety of primiparous women prior to cesarean section. Methods: A randomized controlled trial was carried out on 105 women scheduled for cesarean section. They were randomly assigned into three groups: BRT, MT, and control (n = 35 per group). The women in the BRT and MT groups performed exercises and listened to music, respectively, for 20 minutes prior to cesarean section. The State Anxiety Inventory was used to measure the women's anxiety in the groups before and after the intervention. Results: Within-group comparisons showed that the women in the BRT (t = 5.61, p < 0.001, effect size (Cohen's d) = 0.94) and MT (t = 3.83, p = 0.001, d = 0.64) groups had significantly lower anxiety after the interventions compared to before the interventions. Also, between-group comparisons revealed that anxiety after the intervention was significantly lower in the BRT and MT groups compared to the control group (p = 0.007). Conclusions: Although both of the BRT and MT helped with the reduction of anxiety among primiparous women before cesarean section, the BRT was shown more effective. These nonpharmacologic methods are safe and cost-effective and can improve well-being among women undergoing this invasive procedure. They can be used along with pharmacologic methods for reducing overreliance on medications.

Effectiveness of nurse-led counselling and education on self-efficacy of patients with acute coronary syndrome: A randomized controlled trial.

AIM: Adherence to lifestyle recommendations, medical regimens and cardiac rehabilitation is poor among patients with acute coronary syndrome. The aim of this study was to examine the effect of nurse-led counselling and education using a person-centred care approach on short-term cardiac self-efficacy in patients with acute coronary syndrome. DESIGN: A parallel, two-armed, randomized controlled trial was conducted. METHODS: One hundred twenty patients who were hospitalized with diagnosis of acute coronary syndrome were selected and randomly assigned into intervention (n = 60) or control (n = 60) groups. In the intervention group, in addition to routine care, the nurse-led counselling and education programme included two face-to-face sessions, two telephone counselling and education sessions, using the person-centred care approach. Participants in the control group received only routine care. Data were collected using the cardiac self-efficacy scale before the intervention and 1 month after discharge. RESULTS: After the intervention, we found that cardiac self-efficacy, including the perceived self-efficacy to control symptoms and maintain function, was statistically significantly higher in the intervention group than the control group.

Anxiety and depression among healthcare workers during COVID-19 pandemic: A cross-sectional study.

INTRODUCTION: During a pandemic, healthcare workers (HCWs) are exposed to many stresses that predispose them to psychological disorders. This study aimed to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the anxiety and depression level of HCWs and determine the relationship between them in terms of their demographic characteristics. MATERIAL AND METHODS: This study used a cross-sectional design. The participants consisted of clinical, administrative, and cleaning staff who were working in a referral COVID-19 hospital in an urban area of Iran. The census sampling method was used for recruiting the participants from May to August 2020. The Generalized Anxiety Disorder-7 (GAD-7) questionnaire and the Center for Epidemiologic Studies Depression (CES-D) Scale were employed to collect data. Then, data were analyzed using multivariable linear regression analysis. RESULTS: One hundred forty HCWs participated in this study. The mean scores of anxiety and depression were 6.64 (4.86) and 18.21 (10.59), respectively. There was a significant direct association between anxiety and depression (P < 0.001). In addition, female gender (P = 0.01) and having a history of infection with COVID-19 (P = 0.001) were associated with a higher level of anxiety. Moreover, having a history of being quarantined due to COVID-19 was associated with a higher level of depression (P = 0.03). CONCLUSION: According to the findings of the present study, considering the mental health of HCWs during the generalized anxiety outbreak of COVID-19 should be a priority, and appropriate interventions should be planned to improve their psychological condition.

Effect of Benson and progressive muscle relaxation techniques on sleep quality after coronary artery bypass graft: A randomized controlled trial.

OBJECTIVE: This study aimed to investigate the effect of Benson relaxation (BR) and progressive muscle relaxation (PMR) techniques on the sleep quality of patients undergoing coronary artery bypass graft (CABG) surgery. METHOD: This study was a three-arm, parallel, randomized controlled trial. 120 patients who underwent CABG surgery at two academic hospitals in an urban area of Iran were randomly allocated into three groups (40 per group): the BR, PMR, and control groups. Patients in the BR and the PMR groups performed relevant exercises twice a day for four weeks. Sleep quality was measured before and immediately after the intervention using Pittsburgh Sleep Quality Index. RESULTS: Within-group comparison in the BR (t = 3.51, p = 0.001) and the PMR (t = 4.58, p < 0.001) group showed that the overall sleep quality showed a significant improvement after the intervention when compared to baseline. The between-group comparison showed that both the BR and PMR groups showed significant improvements in subjective sleep quality (F = 3.75, p = 0.02), habitual sleep efficiency (F = 4.81, p = 0.01), and overall sleep quality (F = 5.53, p = 005) when compared to the control group after the intervention. However, no statistically significant differences were identified among the three study groups in terms of sleep latency, sleep duration, sleep disturbances, sleeping medication, and daytime dysfunction after the intervention (p > 0.05). CONCLUSION: The study showed that a four-week program of both PMR and BR can be effective in the overall improvement of sleep quality in patients following CABG. Further research is required to replicate the findings of the present study.

Validation of the Persian version of the comprehensive frailty assessment instrument plus in community-dwelling older adults.

This study aimed to examine the validity and reliability of the Persian Version of the Comprehensive Frailty Assessment Instrument Plus (CFAI-Plus) among community-dwelling older adults. It was completed by 340 older adults ≥60 years. The content and face validity were confirmed based on the opinion of the target group and experts. In the exploratory factor analysis, seven factors were extracted, explaining 62.8% of the total variance. Confirmatory factor analysis showed acceptable fit indices (Root Mean Square Error of Approximation = 0.045; Comparative Fit Index = 0.93; Tucker-Lewis Index = 0.92). Internal consistency was adequate for factors (Cronbach's alpha: range 0.47 to 0.88), and the test-retest reliability was acceptable (intra-class correlation coefficient: range 0.76 to 0.92). A higher CFAI-Plus score were found in those who were older, female, less-educated, single, lived alone, and had inadequate income. This study supports the reliability and validity of the Persian CFAI-Plus in community-dwelling older adults.

The Relationship between Experienced Respiratory Symptoms and Health-Related Quality of Life in the Elderly with Chronic Obstructive Pulmonary Disease.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the diseases that usually present at an advanced age. Respiratory symptoms in patients with COPD are the most important for making treatment decisions and understanding the adverse effects on health-related quality of life (HRQoL). This study aimed to investigate HRQoL in elderly patients with COPD and examine the relationship between this in relation to respiratory symptoms experienced by them and their demographic characteristics. METHODS: This is a descriptive, correlational study of elderly patients with COPD who were hospitalized in five different hospitals in an urban area of Iran. A consecutive sampling method was used. Demographic data form, the respiratory symptoms component of St. George's Respiratory Questionnaire (SGRQ), and the Short Form 36 Health Survey Questionnaire (SF-36) were applied for data collection. RESULTS: The patients (n = 217) reported low HRQoL, and this impairment was more observed in the physical component. There was a significant inverse relationship between the experienced respiratory symptoms and physical (p=0.03) and mental (p < 0.001) components of HRQoL. Moreover, the female gender, the low level of education, the increased duration of the disease, the increased number of hospitalizations during the past year, and the use of two classes of drugs simultaneously were associated with the impaired HRQoL. CONCLUSION: Our findings inform healthcare providers about the negative impacts of respiratory symptoms and other related factors on the HRQoL of elderly patients with COPD. Nurses and other healthcare providers should proactively identify respiratory symptoms and design appropriate caring strategies to improve HRQoL among this group.

Family centered care of hospitalized children: A hybrid concept analysis in Iran.

Background: Family centered care of hospitalized children (FCCHC) is a multidimensional concept, which is directly associated with the context and healthcare system. This study was conducted to analyze the concept of FCCHC in Iran. Methods: This concept analysis was conducted with the use of hybrid model in 3 phases: a literature review in the theoretical phase, semi-structured interviews and descriptive observations in the fieldwork phase, and combination of the results of 2 previous phases in the final analytical phase. Results: The 4 main themes extracted in theoretical phase included "family and healthcare professional participation", "information sharing with families", "family and healthcare professional relationship based on dignity and respect" and "individualized care of family".Moreover, 4 themes were emerged in the fieldwork phase, including "family as a nonparticipant visitor", "one-way education", "non-supportive interactions" and "non-specific care of family". In third phase with combination of the results of 2 phases, the final definition of the concept was presented. Conclusion: FCCHC is a comprehensive care that is affected by human and organizational factors and requires full participation of staff and family, effective interaction with family, education and information sharing with them, and individualized care of each family. By knowing the dimensions of the FCCHC, we will be able to run our activities to provide facilities and features for its optimal implementation in Iran.

Honey and Radiation-Induced Stomatitis in Patients With Head and Neck Cancer.

BACKGROUND: Stomatitis is a common oral complication which affects 100% of patients undergoing head and neck radiotherapy. Acute stomatitis might cause failure and delay radiotherapy. Attention to mouth hygiene, particularly using mouthwash, has a fundamental importance for these patients. OBJECTIVES: The current study came to addresses the effects of pure natural honey on radiation-induced stomatitis in patients with a variety of head and neck cancers. PATIENTS AND METHODS: The present single-blinded nonrandomized controlled trial was conducted on 105 patients undergoing radiotherapy due to head and neck cancer at the radiation unit of Shafa hospital in Kerman, Iran, from October 2012 to March 2012. The research groups were selected by writing the names of the protocols (the mouthwashes of chamomile, honey and the common caring protocol at ward which uses water) on three cubes. The first extracted cube was related to the chamomile mouthwash (Matrica), the second to the honey mouthwash and the last cube to the water mouthwash. The first experimental group (n = 35) gurgled a solution containing 20 mL diluted honey, the second group gurgled a solution containing German chamomile, and the 35 patients in the control group were advised to gurgle 20 mL water (the ward routine). RESULTS: The results showed that severe stomatitis in groups of honey, chamomile and control was 0, 5.7%, and 17.6%, respectively. On the 14th day, it was 0, 0, and 17.6%, respectively. There were significant differences between the three groups regarding the severity of stomatitis in the 14th day (P < 0.001). CONCLUSIONS: The application of natural honey is effective in managing and preventing radiation-induced stomatitis in patients with head and neck cancers.

Quality of Life in Patients Undergoing Percutaneous Transluminal Coronary Angioplasty (PTCA).

BACKGROUND: Coronary artery diseases are the main causes of death in industrial Countries. Transluminal angioplasty is a common technique used to manage the condition of coronary arteries. The purpose of this study was to explore the quality of life in patients sustaining this measure in two stages before the procedure and then three consecutive after that 3, 6 and 12 months respectively. MATERIALS & METHODS: This research was a longitudinal study and data was collected between 2011-2013 years. 115 patients were included. Data were collected through using a questionnaire with 40 questions. The subjects before, 3, 6 and 12 months after the procedure filled out questioner. Data were analyzed by statistical tests including T-test, Fisher exact test, Wilcoxon and Friedman with Software SPSS version 16, P value<0.05. RESULTS: There were significant differences in the quality of life in patients with PTCA before procedure and 3 months after that (P=0.004). Quality of life of patients undergoing PTCA in the four levels, three, six and twelve months after the operation had a significant difference (P<0.001). CONCLUSIONS: Quality of life of people with PTCA operation three months after surgery is reduced. It is required during this period the patient treatment team and supports his family and put under the necessary training in this period to give patients and encourage them to pursue their condition should.