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INTRODUCTION: Low quality of sleep is a common problem among hemodialysis patients. This study was conducted to evaluate the effect of a cold dialysis solution on the quality of sleep in patients undergoing hemodialysis. METHODOLOGY: This double-blind clinical trial was performed on 26 hemodialysis patients with chronic renal failure and sleep disorders in the dialysis center of Sabzevar, Iran, in 2016-2017. Of the 26 patients, 13 each were allocated to the intervention and control groups. The patients in both groups received 4 weeks of hemodialysis (3 sessions per week) using a standard solution with a temperature of 37°C. In the next stage, the control group continued to receive the standard-temperature dialysis, while the intervention group received dialysis using a solution with a temperature of 35.5°C for 4 weeks (3 sessions per week). The Pittsburgh Sleep Quality Index was used to assess and compare the quality of sleep before and after the intervention in the two groups. Data were analyzed using R 1.2.3 software, at 95% confidence level. RESULTS: Although the mean scores of sleep quality were not significantly different between the intervention (9.53 ± 3.12) and control (11.23 ± 3.37) groups at baseline, postintervention, significant differences were observed (intervention group: 4.7 ± 4.55; control group: 10.61 ± 2.69; P < 0.001). CONCLUSION: This study showed that dialysis with cold solution is a simple, cost-effective, and nonpharmacological method that can be used to improve sleep quality in patients undergoing hemodialysis.
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BACKGROUND: Intramuscular (IM) injection is one of the causes of anxiety and pain in patients, using new techniques and creating a pleasant experience is of the legal and ethical duties of nurses. We aimed to investigate comparison of skin traction, pressure, and rapid muscle release with conventional method on IM injection pain. MATERIALS AND METHODS: This clinical trial investigated 28 patients (56 samples) who required Methocarbamol injection. Two 5 cc Methocarbamol were injected for each patient by the conventional and innovative methods. In the innovative technique, after applying skin traction and imposing deep pressure to the muscle, the needle was inserted at a 90° in the muscle and injected after aspiration. However, this deep pressure was not applied in the conventional method. The pain was measured using visual analog scale. STATA software version 12 was used for statically analysis. P < 0.05 was considered statistically significant. RESULTS: The findings showed pain intensity in innovative method and conventional method was 1.17 ± 0.75 and 2.78 ± 1.61, respectively. The difference was statistically significant (P = 0.001). The minimum pain intensity in innovative method was 0 and maximum was 4, meanwhile in conventional injection, the lowest and highest pain intensity was 0 and 6 respectively. CONCLUSION: The results of this study showed that innovative method can be used as a substitute for conventional method to reduce IM injection pain.
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BACKGROUND: Maintaining of oral hygiene has been known as one of the basic tasks of nurses working at intensive care unit. This study aimed to compare the effectiveness of chlorhexidine solution with toothbrush in prevention of oral lesions or ulcers in the different parts of the mouth. METHODS: In this clinical trial study, research Society included patients hospitalized with endotracheal tube since the arrival time in intensive care unit. In this study, 30 patients were selected with target-based approach and equally divided into two groups through the permutation blocking method for oral care toothbrush and toothpaste and using chlorhexidine and swab. The modified form of Beck Oral Assessment Scale (BOAS) and MPS were used to obtain needed information. Data were analyzed by means of R software (version 3.0.2) and also multiple logistic regressions in the confidence level of 95%. RESULTS: This study indicated an association between using toothbrush and the oral health level (OR: 1.52). In different parts of the mouth, there was no difference between two groups in prevention of lesions in gums, lips and tongue while, this was significant in relation to plaque, mucus and teeth with an odd ratio of 3.94 for teeth and 2.75 for mucus . In comparison, there was an association between implying chlorhexidine and saliva health level. (OR: 2.046). CONCLUSION: This survey showed that using toothbrush has a noticeable impact on declining oral lesions in varied parts of the mouth.