Changes in Liver Enzymes in the Patients Undergoing Open Cardiac Surgery and Related Factors

One of the most important gastrointestinal complications following cardiac surgery is hepatic dysfunction. This prospective study was evaluated the incidence and significance of liver dysfunction after open cardiac surgery. This study was conducted on 150 patients who were candidates for heart surgery. Liver tests including bilirubin (total and direct), alkaline phosphatase, AST, ALT were measured before the operation and on the first, third, and seventh postoperative days. Out of 150 patients, 80 were men (53.3) and 70 were women (46.7) with mean age of 62 +/- 12.5. Level of AST, ALT and bilirubin total has increased significantly after surgery (P<0.05). There were significant relationship between AST, ALT and alkaline phosphatase on first day after surgery and hypothermia less than 32 degrees C (P<0.05), blood transfusion more than 6 units (P<0.05), intraoperative hypotension (P <0.001), duration of the pump over 100 minutes (P < 0.001) and smoking (P<0.05). There was significant difference between two groups in length of ICU stay (7.14 +/- 9.17 days in patients with liver enzyme changes VS. 4.11 +/- 2.17 days in patients without liver enzyme changes, p-value<0. 05). Patients with changes in liver enzyme had a longer hospital stay (25.2 +/- 6.48 in patients with liver enzyme changes VS. 9.23 +/- 5.3 in patients without liver enzyme changes, p-value<0. 05). Four deaths occurred among patients with changes in liver enzyme level but there was no death in patients without changes in liver enzyme levels that this difference in mortality rate was statistically significant (<0.005). The results of this study showed that there is a significant relationship between and changes in liver enzymes and hypotension during the, hypothermia, the pump duration, blood transfusion, and the type of the pump

The effects of nurse-led telephone-based support on supportive care needs among women with breast cancer: A randomized clinical trial

Background:Patients with breast cancer (BC) need to be supported in all aspects of their lives. Objectives: This study aimed to evaluate the impacts of nurse-led telephone-based support on supportive care needs (SCNs) in women with BC. Methods:This two-group randomized clinical trial was conducted on 62 women with BC who were randomly assigned to two groups to either receive telephone-based support (n = 31) or conventional care routinely provided to patients with BC (n = 31). Patients' SCNs were assessed before, 2 weeks, and 1 month after the intervention onset using the SCNs Survey -Short Form 34 The data were analyzed through the repeated-measures analysis of variance and the Bonferroni's, Chi-square, Fisher's exact, independent-sample t, and Mann-Whitney U-tests. Results: Significant decreases were observed in the mean scores of SCNs in both groups (P< 0.001), though the decrease in the intervention group was much greater than the control group (39.08 vs. 2.87). Baseline mean score of SCNs in the intervention group was significantly greater than the control group (P = 0.008); however, 2 weeks and 1 month after the intervention onset, the mean score in the intervention group was significantly lower than the control group (P< 0.05). Conclusion: Telephone-based support is effective in addressing and reducing SCNs among patients with BC

Effect of Peer Education before Coronary Artery Bypass Graft on Post Discharge Quality of Life

Abstract Background: Promoting quality of life after Coronary Artery Bypass Graft (CABG) is necessary in order to control the risk factors and reducing the probability of patient readmission. This study was conducted to determine the effect of peer education on patients’ quality of life after coronary artery bypass graft. Materials and Methods: In this clinical trial, two patients with previous coronary artery bypass surgery were trained as peer educators. The patients who were candidate for surgery were systematically allocated to trial or control groups. Before the surgery, both groups received the post CABG self-care in the ward. The trial group (n=40) was taught by the peers, while the control group (n=40) received the routine teaching by the nurses. The quality of life was assessed before, one month and two months after discharging using the SF12 questionnaire. Multivariate Analysis of Variances (MANOVA) was recruited to analyze the data. Results: In the trial group, the mean quality of life scores before the surgery, one month and two month after discharging were 31.82±4.90, 28.06±3.83 and 35.82± 4.96, respectively. In the control group, the scores were 25.58±4.21, 29.31±4.03, and 31.56±6.91. The results indicated significant differences between the groups (p<0.001, F= 13.52). In the peer educated group, the mean scores of quality of life were higher than the control group. Conclusion: The CABG patients᾽ quality of life was significantly higher in the patients who received peer education in comparison with the control group. It seems that peer education may contribute in the patients᾽ self care and promoting their quality of life

Effect of a family-centered clinical intervention on the anxiety of family members of the patients hospitalized in critical care units

Background and Objective: Hospitalization of patients in the intensive care units frequently results in anxiety of the family members. This study was performed to investigate the effect of a family-centered clinical intervention on the anxiety of family members of the patients hospitalized in intensive care units. Methods: In this clinical trail study, eighty family members of the patients hospitalized in the intensive care units were randomly divided into interventional and control groups, respectively. In the interventional group, the family members were allowed to be present at the bedside from the second till the sixth day.The participant's level of anxiety was assessed in the second and the sixth day of patient's hospitalization using hospital anxiety and depression scale. Oral information about the equipment and the regulations and, a daily information card consisting of treatment and care activities, vital signs and patient's level of consciousness was delivered to the participants and their questions were answered. Results: In the the sixth day, there was a significant difference between the mean anxiety scores in the intervention (11±3.22) and control group (7.05±3.44) (P<0.05). Also, the frequncey of anxiety in the interventional group (56%) was significantly higher than the control group with 15% (P<0.05). The odds ratio for anxiety in sons/daughters was lower than other family members in the sixth day (P<0.05). Conclusion: Providing information, presence at the bedside and participation in the care of their patient increase the anxiety of family members in the first week of patient hospitalization in the intensive care unit