RESUMO
BACKGROUND: Chronic renal failure is among the major health challenges in the world. Many clinical trials have been conducted to assess the effects of complementary and alternative therapies on hemodialysis-related outcomes. However, a number of biases may affect the results of these studies. AIMS: This study aimed to assess biases in randomized clinical trials into the effects of complementary and alternative therapies on hemodialysis patients. SETTINGS AND DESIGN: A critical review on clinical trials into the effects of complementary and alternative therapies therapies on hemodialysis patients. MATERIALS AND METHODS: This study was conducted on 114 randomized clinical trials which had been published in 2012-2017 into the effects of complementary and alternative therapies on hemodialysis patients. The Cochrane Risk of Bias Tool was employed to assess biases in the included trials. The collected data were presented using the measures of descriptive statistics, namely absolute and relative frequencies. RESULTS: Among 114 included trials, 71.05% (81 trials) had used low bias methods for random sequence generation, while 60.52% (69 trials) had provided no clear information about allocation concealment. Moreover, respecting blinding, 57.89% of trials (66 trials) were low bias. Around 60.52% of trials (69 trials) had no attrition between randomization and final follow-up assessment and 84.21% (96 trials) had apparently reported all intended outcomes. CONCLUSIONS: This study shows that 50% of randomized clinical trials into the effects of complementary and alternative therapies on hemodialysis patients have low bias. Yet, quality improvement is still needed to produce more conclusive evidence.
RESUMO
BACKGROUND: Parents of children with cancer experience high levels of stress and discomfort. Religious beliefs are important sources of comfort and support for many cancer patients and their families. The present study aimed to assess the effect of educational-spiritual intervention on burnout of the parents of the children with cancer. METHODS: In this randomized clinical trial, 135 parents of children with cancer were randomly assigned into intervention and control groups. Data were collected through SMBQ (Shirom and Melamed Burnout Questionnaire) from both groups, before, immediately after and one month after the intervention. Educational-spiritual programs were held for six weeks, one session every week. The data were analyzed by SPSS using independent t-test, and repeated measure ANOVA. RESULTS: The results showed that the mean burnout score before the intervention in the intervention group was 4.28±0.61 and in the control group it was 4.23±0.50; most of the parents reported moderate to high burnout. But, there was a significant difference between the intervention and control groups immediately after and one month after the intervention (t=10.16, P<0.0001). The mean burnout score in the intervention group was less than the control group. Results also showed that there was a significant difference between the two groups in terms of parental burnout in three times of measurements (F=58.62, P<0.0001). CONCLUSION: This study indicated that educational-spiritual intervention was effective on reduction of the burnout of the parents of the children with cancer. Due to high burnout of most of the parents, offering such a program could be beneficial for them. More studies in this regard are recommended. TRIAL REGISTRATION NUMBER: IRCT2014061818144N1.
