Comparative Study of Job Burnout Among Critical Care Nurses With Fixed and Rotating Shift Schedules

Background: Nurses, as health care providers, are insurmountably obliged to the practice of shift work. Literature has reported shift working as one of the inducing factors of burnout. Despite numerous studies in this area, there are inconsistencies on the relationship between shift working and burnout among nurses, especially in those who work in critical care settings. Objectives: The aim of this study was to compare the occupational burnout in critical care nurses with and without fixed shift schedules. Patients and Methods: In this comparative study, 130 nurses with rotating shift schedule and 130 nurses with fixed shift schedule from six university hospitals were selected using stratified random sampling. Maslach burnout inventory was used for data collection. Independent samples t-test, chi-square and one-way ANOVA tests were used to analyze the data. Results: Most of the participants were females (62.7%), aged between 22 - 29 years (38.5%), married (59.2%), and had a bachelor degree (86.9%). The mean score of emotional exhaustion was significantly higher in nurses with fixed shift schedules (P 0.05). Moreover, no significant difference was found in burnout mean scores between nurses with fixed morning and fixed night shifts (P > 0.05). The means of the emotional exhaustion subscale were significantly different in nurses with different characteristics (P < 0.05) except the gender and working unit. Conclusions: As a result of this study, it was found that critical care nurses with fixed shift schedules display more burnout in emotional exhaustion dimension, compared to those working with rotating shift schedules

The Effect of Music on Anxiety and Cardiovascular Indices in Patients Undergoing Coronary Artery Bypass Graft: A Randomized Controlled Trial

Background: The instability of cardiovascular indices and anxiety disorders are common among patients undergoing coronary artery bypass graft (CABG) and could interfere with their recovery. Therefore, improving the cardiovascular indices and anxiety is essential. Objectives: This study aimed to investigate the effect of music therapy on anxiety and cardiovascular indices in patients undergoing CABG. Patients and Methods: In this randomized controlled trial, 60 patients hospitalized in the cardiovascular surgical intensive care unit of Shahid Beheshti Hospital in Qom city, Iran, in 2013 were selected using a consecutive sampling method and randomly allocated into the experimental and control groups. In the experimental group, patients received 30 minutes of light music, whereas in the control group, patients had 30 minutes of rest in bed. The cardiovascular indices and anxiety were measured immediately before, immediately after and half an hour after the study. Data were analyzed using the chi-square test and repeated measures analysis of variance. Results: Compared to the immediately before intervention, the mean anxiety scores immediately after and 30 minutes after the intervention were significantly lower in the experimental group (P 0.05). Conclusions: Music therapy is effective in decreasing anxiety among patients undergoing CABG. However, the intervention was not effective on cardiovascular indices. Music can effectively be used as a non-pharmacological method to manage anxiety after CABG

Effect of Minimally Invasive Endotracheal Tube Suctioning on Suction-Related Pain, Airway Clearance and Airway Trauma in intubated Patients: A Randomized Controlled Trial

Background: Due to the frequency and risks associated with endotracheal suctioning, there is a need to examine clinical practice critically and identify clinical research to guide practice. Correct technique and preparation by the clinicians can assist to reduce the risks of adverse events and the level of discomfort for the patients. Objectives: The current study aimed to investigate the effects of routine versus the minimally invasive endotracheal tube suctioning procedure on suction-related pain, airway clearance and airway trauma in patients who were intubated. Methods: In this randomized clinical trial, 64 patients with intubation in the intensive care units (ICUs) of Alzahra Hospital, Isfahan, Iran, were randomly allocated to minimally invasive endotracheal tube suctioning (MIETS) and routine endotracheal tube suctioning (RETS) groups. Pain intensity was assessed immediately before, immediately after and 10 minutes after endotracheal tube suctioning (ETS). Airway clearance was defined by numbers of suctioning and airway trauma noted after suctioning. The Chisquare test, independent T-test, and repeated measures analysis of variance were performed to analyze the data. Results: There wasnosignificant difference in thenumberof suctions needed to effectively clear airway between the two groups. No significant differences were observed in the pain score changes during the three -time measurements in the MIETS group. However, in the RETS group the increase of pain scores were statistically significant during the three- time measurements. In addition, the numberof airway traumatizationwassignificantly higher in the RETS group. Thenumberof medications used as a pain relief during 10 minutes after the ETS was significantly higher in the RETS group. Conclusions: The results of the study suggest that using MIETS instead of RETS caused a lower incidence of airway traumatization and lower suction-related pain intensity. In addition, MIETS was sufficiently effective, the same as RETS, to remove airway secretions. Hence, MIETS may be useful to reduce the complications of ETS as long as being effective to remove airway secretions

Predictive value of transcutaneous bilirubinometry on third day of birth in diagnosis of hyperbilirubinemia in term and near-term neonates

Introduction: Severe hyperbilirubinemia may cause side effects such as hearing impairment or bilirubin encephalopathy. In this way, transcutaneous bilirubinometry (TCB) is a non-invasive screening method, which is performed using BiliCheck and does not require frequent blood sampling, time and cost. The aim of this study was to determine the predictive value of TCB on third day of birth in neonatal hyperbilirubinemia diagnosis in term and near-term neonates. Materials and Methods: A test assessment method was chosen with continuous sampling in 388 neonates 35 weeks and more at AkabarAbadi hospital in Tehran in 2011. On the third day of birth, cutaneous bilirubin levels (TCB) in the forehead by using BiliCheck and serum bilirubin (TSB) was measured from the heel capillary sample and consequently were compared with each other. Results: In neonatal hyperbilirubinemia diagnosis on the third day of birth, cutaneous bilirubin measurement had the sensitivity of 82 with the confidence interval (78.2, 85.7), specificity of 99.3 with the confidence interval (98.7, 99.9), positive predictive value of 92.9 with the confidence interval (88.0, 96.2) and negative predictive value of 94.8 with the confidence interval (92.8, 96.8). Generally, the third day measurement of cutaneous bilirubin had a predictive value of 94.5 in detecting high-risk neonates for hyperbilirubinemia. Conclusion: Third day TCB, in addition to being non-invasive and convenient use, has a high predictive value to detecting the risk of hyperbilirubinemia in neonate and it is recommended to use hyperbilirubinemia screening. © 2019, Semnan University of Medical Sciences. All rights reserved

Exposure to heat stress in the workplace: A systematic review

Background and aims: Working in hot environments is one of the common physical risks factor in the workplace, which can also cause heat-related illnesses and various health effects on workers, and also increasing the risk of injuries and occupational accidents. The purpose of this paper is review conducted studies about heat stress in different countries, investigation the indices of heat stress, the characteristics of the exposure in hot environments, high-risk occupations, and sutvey the status and importance of these studies. Methods: In this review study used Web of Science, Scopus, Pubmed, ScienceDirect, Iran Medex, Magiran, Google Scholar and SID databases. The keywordsincluded Heat stress, Heat strain, Heat exposure, Heat waves, Workplace, Knowledge and attitude of workers about heat stress, the period of 2000 to 2015 was investigated, and finally 103 original articles were identifed. Results: 90 of all study being cross-sectional studies, 41 being related to outdoor workplaces, and 42 being related to indoor environment. 19 studies were about perceptions and behavioural responses of exposure to heat stress.A range of heat indices were used with 60 (71) studies using Wet Bulb Globe Temperature Index (WBGT). Most of studied focused on manufacturing workers and farmers. Most of studies indicated that workers were suffering from heat stress and strain. Conclusion: The results of reviewed studies showed that stress in workplace is worrying due to the nature of the working processes both indoor and outdoor, and of climate change. Therefore it is necessary to considering preventive and control programs to reduce the heat stress by the management and staff's participation to eliminate or reduce its lethal effects. © 2018 JTehran University of Medical Sciences and Health Services. All rights reserved

Clinical Manifestations of Gastrointestinal Symptoms in COVID-19 Patients: An Integrative Review

After the outbreak of novel coronavirus disease 2019 (COVID-19) in Wuhan, China, its spread to other countries is rapidly increasing. In this integrative review, we report the prevalence of gastrointestinal symptoms in patients with COVID-19. For this purpose, available articles on gastrointestinal manifestations in patients with COVID-19, which were reported from China, were reviewed. All reviewed articles were searched from December 11, 2019, to June 20, 2020, based on specific key words. Related findings in these articles show that the main target of COVID-19 is lung tissue, as after the virus enters the body, it mainly causes respiratory symptoms in affected patients. But in addition to respiratory symptoms, it is possible that, over time, these patients present with other symptoms, the most obvious of which are gastrointestinal symptoms. It is well documented that diarrhea and vomiting are the most common gastrointestinal symptoms in COVID-19 patients. As part of this report, we also look at the incidence and frequency of gastrointestinal symptoms in COVID-19 patients in Iran. The results can be used by providers as a guideline for better management of gastrointestinal symptoms in these patients. © 2021 Lippincott Williams and Wilkins. All rights reserved

Predictive value of transcutaneous bilirubinometry on third day of birth in diagnosis of hyperbilirubinemia in term and near-term neonates

Introduction: Severe hyperbilirubinemia may cause side effects such as hearing impairment or bilirubin encephalopathy. In this way, transcutaneous bilirubinometry (TCB) is a non-invasive screening method, which is performed using BiliCheck and does not require frequent blood sampling, time and cost. The aim of this study was to determine the predictive value of TCB on third day of birth in neonatal hyperbilirubinemia diagnosis in term and near-term neonates. Materials and Methods: A test assessment method was chosen with continuous sampling in 388 neonates 35 weeks and more at AkabarAbadi hospital in Tehran in 2011. On the third day of birth, cutaneous bilirubin levels (TCB) in the forehead by using BiliCheck and serum bilirubin (TSB) was measured from the heel capillary sample and consequently were compared with each other. Results: In neonatal hyperbilirubinemia diagnosis on the third day of birth, cutaneous bilirubin measurement had the sensitivity of 82 with the confidence interval (78.2, 85.7), specificity of 99.3 with the confidence interval (98.7, 99.9), positive predictive value of 92.9 with the confidence interval (88.0, 96.2) and negative predictive value of 94.8 with the confidence interval (92.8, 96.8). Generally, the third day measurement of cutaneous bilirubin had a predictive value of 94.5 in detecting high-risk neonates for hyperbilirubinemia. Conclusion: Third day TCB, in addition to being non-invasive and convenient use, has a high predictive value to detecting the risk of hyperbilirubinemia in neonate and it is recommended to use hyperbilirubinemia screening. © 2019, Semnan University of Medical Sciences. All rights reserved

The Effects of Heat Stress on Selective Attention and Reaction Time among Workers of a Hot Industry: Application of Computerized Version of Stroop Test

Introduction: Working in hot and inappropriate climate condition is one of the most common problems of occupational health which can lead to heat induced diseases and even death. Heat stress may impair the cognitive processes involved in decision-making and converting simple tasks to complex ones. The aim of present study was to assess selective attention and reaction time among workers in a casting unit of a car manufacturing industry and to investigate the effects of heat stress on mentioned variables. . Material and Method: In this retrospective cohort study 70 workers from a hot industry were selected in two of exposed and control groups. First, demographic questionnaire was completed for each of the participants and noise and light were measured as the likely confounding factors. Stroop test 1, 2, and 3 were done before and during the work in order to determine the effects of heat on selective attention and reaction time. Besides,WBGT were measured at the ankle, waist, and head levels. Data were analyzed using SPSS software, version 18. Result.: WBGT measurements showed that the mean WBGT were 33 and 16.7 for the exposed and not exposed groups, respectively. Moreover, no significant relationships were observed between test duration, reaction time, and number of errors in Stroop tests 1 and 2 and the level of heat (P-value<0.0001). However, the mentioned variables had a significant positive correlation with Stroop test 3. Additionally, for exposed group variables of test duration, reaction time, and number of errors in Stroop 3 were significantly higher than those of control group. .Conclusion: According to the findings in present study, heat stress causes an increase in reaction time and a decrease in selective attention. Thus, heat can be assumed as a stressor in hot work environments and the heat should be taken into account while design of job and tasks which needed selective attention or reaction time

The effect of licorice on depression of nurses

Introduction: Nurses are at risk of depression due to the nature of their work environment. This study was conducted to determine the effect of Licorice on depressive symptoms in nurses, regarding the importance of the role of nurses in the health care system. Methods: This study is a triple blind placebo controlled clinical trial, in that initially, 72 eligible persons working in internal & surgical wards of teaching hospitals of Arak, were selected using convenience sampling. After obtaining written consent from them, they were put randomly in one of the intervention and control groups. Subjects of the intervention group received 380mg D-reglis tablets and subjects in the control group received placebo which looks like D-reglis (3 tablets for 4 weeks). After intervention, subjects again completed the Beck Depression Inventory and data were analyzed using paired t-test, independent T-test and Chi-square tests. Results: The mean depression score of nurses in the experimental group before taking the drug was 19.22±7.686 that changed to 13.10±7.757after the intervention. Also the mean of this index in the control group was 20.5±7.507 before the intervention and 19.72±7.456after the intervention. There was significant difference between the mean of depression in the intervention group before and after the intervention (p=.001). In the control group, there was not any significant difference (p=.079). Furthermore, there was a significant difference between the mean score of depression in intervention and control groups after the intervention (p=.001). Conclusion: According to the results, it seems that this drug can be used to reduce the depressive symptoms