Interventions to Improve Inpatients’ Sleep Quality in the Intensive Care Unit and Acute Ward Settings: A Qualitative Literature Review

Background: Sleep is essential for the physical and psychological restoration of inpatients, and lack of sleep results in sleep deprivation and poor sleep quality, with potentially harmful consequences. Aim: To summarise sleep-promoting interventions in the Intensive care unit (ICU) and acute ward setting. Method and results: Six databases were searched to obtain studies for review and eight studies were selected, appraised, analysed and produced two themes: sleep-disturbing factors and sleep-promoting strategies. Sleep-disturbing factors included environmental factors (such as light and noise), illness-related factors (such as pain, anxiety and discomfort), clinical care and diagnostics. Sleep-promoting strategies included using pharmacological aids (medication) and non-pharmacological aids (reducing noise and disturbances, eye masks, earplugs and educational and behavioural changes). Conclusion: The literature review showed that both ICU and acute ward settings affect patients' sleep and both use similar strategies to improve this. Nevertheless, noise and sleep disturbances remain the most critical sleep-inhibiting factors in both settings. The review recommended future research should focus on behavioural changes among health professionals to reduce noise and improve patients' sleep

Depression and its associated factors in the caregivers of hospitalized patients with cancer

Objective: Cancer diagnosis can confront the patients’ first care and support source, their family and caregivers, with a serious crisis, likewise, they may show depressive symptoms. Paying attention to such an issue is of special importance in promoting the patients’ health. Therefore, this study was conducted to determine the extent of depression and related factors in hospitalized cancer patients’ caregivers. Materials and methods: In the present descriptive-analytical study, 152 caregivers of hospitalized patients with cancer in Imam Khomeini hospital in Sari (Mazandaran, Iran) were selected using available sampling in 2018. The data gathering instruments included demographic and medical information questionnaire of both the caregivers and patients, and 21-item Beck depression inventory. The data were analyzed using SPSS 16 along with the descriptive statistics and inferential statistical tests such as Chi-square and Pearson correlation coefficients. Results: According to the results, the mean depression of caregivers was 13.97±10.19, suggesting the minimum level of depressive symptoms. Nevertheless, 25.6% had moderate to severe depression. Variables such as care hour, marital status, place of residence, depression history, incidence of depression over the past six months, financial status, and the relation between the patient and caregivers had a significant relationship with depression (p0.05). Conclusions: Considering the supportive role of caregivers and their impact in promoting the patients’ health, it is recommended that training programs and classes be developed to reduce depression, as well as the possibility of periodic screening of companions in hospitals and, if necessary, referral to a psychiatrist in severe cases should be provided

The effect of honey and diet education on symptoms of functional dyspepsia: A randomized clinical trial

Background: Functional dyspepsia is one of the most common and disturbing symptoms that affect many patients visiting health care centers. Objectives: This study was intended to examine the efficacy of honey and diet education in functional dyspepsia symptoms. Methods: This randomized clinical trial was conducted on 60 patients with functional dyspepsia symptoms in two groups. Patients from both groups received necessary education provided by a gastroenterology subspecialist for modifying their dietary patterns. Experimental group patients also received a teaspoon of honey per day, 30 minutes before each meal for 30 days. The severity of each symptom was measured using the Visual Analogue Scale. Results: A total of 30 patients in each group were assessed. Patients’ mean age was 35.7 ± 12.24 and 40.22 ± 11.43 years in the experimental and control groups, respectively. There was no significant difference between the groups in terms of demographic characteristics (P ≥ 0.05). There were significant differences in the signs of functional dyspepsia before and after the intervention in both groups (P < 0.05). Mann-Whitney U test showed no significant differences between the experimental and control groups in any of the symptoms after the intervention (P ≥ 0.05). Conclusions: The consumption of honey alone was unable to affect gastrointestinal factors in patients with functional dyspepsia. However, the improvement of symptoms in both groups due to the dietary pattern education is worth considering. © 2018, Author(s)

Coping strategies of iranian elderly women: A qualitative study

Successful aging is a process through which older people actively deal with their age-related changes. This study, as a part of more extensive research, explored and describes coping strategies used by Iranian elderly women in response to age-related changes. Grounded theory was used as method. Nineteen participates were recruited. The participants used problem-focused (problem solving, spending leisure time, confrontation) and emotion-focused (self-control, distancing, praying, avoidance, and escape) strategies to manage age-related changes and to keep themselves away from harm. Policy makers, nurses, and other health care providers can use the findings for developmental, educational, and preventive purposes. © Taylor & Francis Group, LLC

The Assessment of the effects of verbal and performance education on nurses' skill in the use of metered dose inhaler

AbstractBackground and purpose: Inhaled drugs increase the effect of medications prescribed in the treatment of chronic airways diseases with fewer side effects compared to other methods. There are many users of metered dose inhaler (MDI), but the rate of improper use in patients, nurses and general practitioners is high. The purpose of this study was a) to assess the rate of MDI misuse in patients compared to nurses and b) to evaluate the effect of verbal and practical education in the use of MDI in nurses.Materials and Methods: Following ethical approval from Medical Ethics Board of the Mazandaran University of Medical Sciences, the present study was carried out in two separate stages. In the first stage which was a cross-sectional study, 110 subjects (55 nurses and 55 patients) were recruited from Mazandaran University Hospitals through a non-randomly and purposeful sampling method. A 0 -100 scale check list was used to measure the skill of nurses and patients in the use of MDI. In the second stage, a randomized clinical trial was designed to assess the effect of verbal and practical education in the use of MDI on 55 nurses (experimental group=25, control group=30). Nurses in the experimental group only, received the education and they were then asked to administer MDI after three weeks.Results: The mean score for patients' skill was 63+37 which was not significantly correlated with age. The two lowest scores were related to slow inspiration (52.7%) and coordination between inspiration and using MDI (52.8%). The mean score for nurses' skill was 51±21/2. The lowest score was related to performance of a deep exhalation and holding the spray at 2.5-5cm distance (21.8%).Data analysis indicated that there was a significant difference between pre and post education score in the experimental group using paired t-test (P=0.0001, T=16.26). There was also a significant difference between the experimental and control group on MDI skill using t-test (p=0.0001, T=-8.19).Conclusion: The results of this study demonstrate that patients had higher score compared with nurses in the use of MDI. It is also shown that educational program may have an important role in improving nurses' skill in the administration of MDI

The Effect of Self-selected Soothing Music on Fistula Puncture-related Pain in Hemodialysis Patients

OBJECTIVE: This study was intended to examine the effect of selective soothing music on fistula puncture-related pain in hemodialysis patients. MATERIALS AND METHODS: This is a randomized clinical trial in which 114 participants were selected from two hemodialysis units by means of a non-random, convenience sampling method. The participants were then allocated in three groups of music (N = 38), headphone (N = 38), and control (N = 38). The fistula puncture-related pain was measured 1 min after venipuncture procedure in all three groups. The music group listened to their self-selected and preferred music 6 min before needle insertion into a fistula until the end of procedure. The headphone group wore a headphone alone without listening to music 6 min before needle insertion into a fistula until the end of procedure. The control group did not receive any intervention from the research team during needle insertion into a fistula. The pain intensity was measured immediately after the intervention in all three groups. RESULTS: This study showed a significant difference between the music and control groups, and the music and headphone groups in terms of the mean pain score after the intervention. However, the analysis did not indicate any significant difference between the headphone and control groups with regard to the mean pain score after the intervention. CONCLUSION: It is concluded that music can be used effectively for pain related to needle insertion into a fistula in hemodialysis patients. Future research should investigate the comparative effects of pharmacological and non-pharmacological interventions on fistula puncture-related pain

Comparing the Effect of Erythromycin and Ginger Extract on the Gastric Residual Volume in Patients Receiving Enteral Nutrition Order in the Intensive Care Unit

BACKGROUND AND OBJECTIVE: Gastric residual volume is considered as an important parameter for gastric emptying and feeding tolerance. This volume is measured before each time of feeding and it has direct effect on the volume and time of the next feeding. Ginger is one of the medicinal plants that have effect on gastric emptying rate. This study aims to compare the effect of erythromycin and ginger extract on gastric residual volume in patients receiving enteral nutrition order in the intensive care unit. METHODS: This randomized clinical trial was conducted among 74 patients hospitalized in the intensive care unit. Patients were fed with similar nutrition formula every 3 hours for 24 hours. Before each gavage feeding, the gastric residual volume of patients was aspirated and recorded. The gastric residual volume of 28 patients (more than 200 cc) was allocated to one of the groups of erythromycin (n = 13) and ginger (n = 15). Patients were fed with 2.5 mg/kg erythromycin in 4 divided doses or 2 grams per day ginger extract in 4 divided doses. The gastric residual volume was recorded for 4 consecutive days and the data obtained from the two groups were compared (IRCT: 201505257494N13). FINDINGS: The mean difference of gastric residual volume in erythromycin group was 111.71±7.04 cc before the intervention and 4 days after that, which was not statistically significant. This difference was 108.61±11.47 cc in ginger group. Results demonstrated that mean gastric residual volume in erythromycin and ginger groups were 98.52±27.88 cc and 95.71±18.91 cc, respectively during the first 4 days and there was not a statistically significant difference between these two groups. CONCLUSION: Results of the study demonstrated that the effect of ginger is very similar to erythromycin. Therefore, ginger can be a proper substitute for erythromycin to prevent increased gastric residual volume in patients hospitalized in the intensive care unit

Self-Care in Iranian Cancer Patients: The Role of Religious Coping

This is the author accepted manuscript. The final version is available from Springer via the DOI in this recordReligious and spiritual practices are related to physical and mental health. Social support is an important source to aid coping, but this is not without its difficulties. This study was conducted to investigate the relationship between religious coping and self-care in a sample of Iranian cancer patients. In this cross-sectional study (October–December, 2015), 380 cancer patients were entered into the study using non random sampling (accessible sampling). Data were collected using socio-demographic, religious coping (R-COPE), and self-care questionnaires. Male patients (48.39 ± 13.39; 95% CI 46.41–50.38) were older than the females patients (45.33 ± 18.44; 95% CI 42.79–47.87). The findings indicated that there was a significant correlation between self-care and positive religious coping (r =.188, p =.009). Also there was a significant relationship between self-care and a history of smoking (p <.05). It seems that improving the level of positive religious affiliation can have beneficial effect on the self-care of cancer patients. Therefore, it is necessary to conduct these studies with greater scale and more different societies to achieve more reliable results about the effects of religious coping on self-care behaviors in cancer patients

LungSong Screen Dance

From breaching breaths to wild dialects with the clouds, LungSong brings attention and feeling to the scientific labor of climate change research through an activation of relations between bodies, airs, atmospheres and cosmologies. Catalysed by a residency at the Lauder Atmospheric Research Station (NIWA) and meetings with scientists and technicians who are involved in ‘ground truth’ readings and data collection of the changes taking place in our atmosphere due to global warming, LungSong is an eco-feminist response to the temper(ature) of our times. LungSong is an ongoing event of reckoning with the state we are in - responsive and resistive, eruptive and sensing - it is shaped by the living experience of planetary and human breaths and the writings of Luce Irigaray