Effects of Yakson Therapeutic Touch and Heel Warming on Pain Caused by Heel Stick Procedure, Vital Signs, and Cry Duration in Full-term Neonates

Background: Neonates are more sensitive to pain and likely to suffer from its long-term complications. Therefore, various methods including non-nutritive sucking, sensory stimulations, and various supportive interventions are employed to relieve pain in newborns. Aim: This study aimed to compare the effects of Yakson therapeutic touch and heel warming on pain caused by heel stick procedure, vital signs, and cry duration in full-term neonates. Method: This randomized clinical trial was conducted among 78 full-term newborns referred to healthcare centers in Mashhad, Iran, 2017. They were assigned into three groups of Yakson theraputic touch, heel warming using a hot-water bottle with the temperature of 40°C, and control receiving routine care, through randomized block method. Then, vital signs before and after and pain intensity after heel-stick procedure were measured using Neonatal Infant Pain Scale (NIPS). Data analysis was performed using Kruskal-Wallis and Wilcoxon tests in SPSS software, version 16. Results: The study groups were homogeneous considering demographic characteristics. The results of Kruskal-Wallis test showed a significant difference between the groups regarding the mean scores of the NIPS at the post-intervention phase (P=0.02). However, no significant difference was observed between pre- and post-intervention phases in the groups considering respiratory and heart rates. Additionally, cry duration significantly reduced in the group that received Yakson therapeutic touch (P=0.03). Implications for Practice: The use of Yakson therapeutic touch could relieve pain, soothe the neonates, and shorten cry duration in newborns after heel stick procedure. Nevertheless, heel warming only increased up blood flow for easier blood sampling

Factors Associated with Poor Blood Pressure Control Among Hypertensive Patients in Rural Region of Mashhad, Iran

Hypertension is one of the most common and important cardiovascular disease risk factors. Poor blood pressure control patients have higher risk for developing complications related to hypertension. However, previous studies showed that the incidence of poor blood pressure control is unacceptably high. A cross-sectional study was conducted to determine the factors associated with poor blood pressure control among 390 hypertensive patients, aged 30 and above in the rural region of Mashhad, Islamic Republic of Iran. A simple random sampling technique was used to select the respondents. The data were collected from 6th September 2010 to 20th December 2010 (3.5 months) .All subjects were interviewed face- to- face privately using pre-tested questionnaire by researcher. Two blood pressure measurements were taken from all respondents using a sphygmomanometer. Poor blood pressure control was defined as having a mean systolic blood pressure of 140 mmHg and above, and/or a mean diastolic blood pressure of 90 mmHg and above. The response rate for this study was 95.5%. The percentage of poor blood pressure control among respondents was 54.6%. The mean age of the respondents was 63.56 ± SD 12.92 years and ranged from 32 to 90 years. The mean age of male respondents was 70.26 ± SD 10.87 and the mean age of female respondents was 60.17 ± SD 12.56 years old. There were significant associations between blood pressure controlled status and level of education ( p< 0.001), job ( p = 0.001), history of smoking ( p = 0.001 ), duration of taking anti-hypertensive drugs ( p = 0.043 ), number of anti-hypertensive used ( p< 0.001), frequency of anti-hypertensive drug used per day (p = 0.001), compliance to medication ( p< 0.001 ), follow-up with nurse monthly ( p = 0.041 ), follow-up interval with doctor ( p< 0.001 ), blood pressure control during last follow-up ( p< 0.001 ), and knowledge on the target measurement of blood pressure control ( p = 0.033 ). However, the results of logistic regression analysis showed that factors associated with poor blood pressure control were low level of physical activity (OR = 131.30; 95%CI 34.52 – 499.33); overweight (OR = 3.42; 95%CI 1.52 – 7.71); obese (OR = 5.91; 95%CI 1.97 – 17.78); poor blood pressure control during last follow-up (OR = 17.42; 95%CI 8.02 – 37.80); taking one anti-hypertensive drug (OR = 11.32; 95%CI 4.08 – 31.42); not comply to medication (OR = 3.62; 95%CI 1.74 – 7.55); and had follow-up interval with doctor for more than three months (OR = 5.82; 95%CI 2.36 – 14.35). This high percentage of poor blood pressure control among respondents implies the need of comprehensive hypertensive patient management program including behavioral modification, aggressive pharmacology management, compliance monitoring, and also regular follow-up with doctor. Keywords: Poor blood pressure control, hypertension, behavioral, compliance. Anti-hypertensive drug