Explaining the Process of Spiritual healing of Critically-ill Patients: A Grounded Theory Study

BACKGROUND: Spiritual healing is one of the most intriguing category of alternative and complementary medicine. The aim of this study was to explain the process of spiritual healing in patients with refractory diseases in Iran.METHODS: This grounded theory study was conducted in Iran from 2018 to 2019. The participants were 14 patients with refractory diseases and 4 healers whom were first selected through purposeful and then theoretical sampling. Semi-structured interviews were used to collect data on patients and healers. All the interviews were transcribed verbatim. Data were coded and grouped under specific categories and analyzed using the Strauss and Corbin’s approach (2008).RESULTS: Four main categories emerged from data analysis including: I) frustration to initial acceptance II) disbelief to trust III) evaluation to action and IV) doubt to certainty.CONCLUSION: The results of our study provide context-specific factors affecting the complex and multifactorial nature of spiritual healing process in patients with refractory diseases. Health care professional can use these findings in designing and implementing appropriate interventions to integrate spiritual healing into their holistic practices of care.

Level of Patients’ Satisfaction from Emergency Medical Services in Markazi Province; a Cross sectional Study

مقدمه: یکی از روش های ارزشیابی خدمات، سنجش میزان رضایتمندی از کیفیت ارائه آنها می باشد. رضایتمندی بیمار مفهومی است که امروزه در مراقبت های پزشکی اهمیت بسیار ویژه ای یافته است  و این امر در سیستم اورژانس پیش بیمارستانی از اهمیت بیشتری برخوردار است. لذا این مطاله با هدف بررسی میزان رضایتمندی از خدمات اورژانس پیش بیمارستانی شهرستانهای تابعه دانشگاه علوم پزشکی اراک انجام شده است. روش کار: در این مطالعه مقطعی جهت بررسی رضایتمندی بیماران از پرسشنامه پایا و روای مقیاس رضایتمندی مراقبت های اورژانسی استفاده شد. این پرسشنامه  متشکل از 33 سوال بود که 9 سوال جهت بررسی اطلاعات دموگرافیک و مابقی در حیطه های مختلف شامل وضعیت وسیله آمبولانس، نحوه برخورد تکنسین ها، میزان حرفه ای بودن، عملکرد تکنسین ها، کارایی اورژانس و یک سوال درباره میزان رضایت کلی از خدمات اورژانس پیش بیمارستانی بود. در نهایت اطلاعات جمع آوری شده با استفاده از نرم افزار SPSS و آماره های توصیفی و تست های مناسب مورد تجزیه و تحلیل آماری قرار گرفتند. يافته ها: کل ماموریتهای انجام شده در این مقطع زمانی 12564 مورد بود. بیشترین ماموریتها متعلق به شهرستان اراک (65%) و کمترین آنها متعلق به شهرستان آشتیان (9/%) بود. تعداد 366 نفر در این مطالعه شرکت کردند. اکثر بیماران شرکت کننده در این مطالعه (59%) مرد بوده و بیشتر آنها (56%) مدرک تحصیلی زیر دیپلم داشتند. همچنین اکثر (52%) آنها سابقه بستری در بیمارستان نداشته و تعداد متاهل ها بیش از مجرد ها بوده است (71%). نمره کل رضایتمندی با جنس (001/0 > p)، وضعیت تاهل (001/0 > p)، سطح تحصیلات (001/0 > p)، محل زندگی (001/0 > p) و سابقه برخورد با اورژانس (015/0 = p) ارتباط دارد. بر این اساس زنان، متاهلین، افراد دارای سطح تحصیلات پایین تر و کسانی که دارای سابقه برخورد با اورژانس بودند، نمره رضایتمندی بیشتری را گزارش کرده بودند. میانگین نمره رضایتمندی  اورژانس دانشگاه علوم پزشکی اراک در قسمت اتومبیل آمبولانس5/14 ± 7/0، نحوه برخورد تکنسین ها با بیمار و همراهان 5/15±7/83، حرفه ای بودن تکنسین ها 15±4/83، عملکرد تکنسین ها 14 ± 7/82، کارایی اورژانس پیش بیمارستانی 4 ± 7/89 و در نهایت نظر کلی بیمار 14 ± 5/82 بود. نمره کلی رضایتمندی در شهرستانهای تابعه دانشگاه علوم پزشکی اراک دارای تفاوت معناداری بود (001/0 > p) . نتيجه گيری: نتایج مطالعه حاضر نشان داد میزان رضایتمندی بیماران از خدمات اورژانس پیش بیمارستانی در حد مطلوب می باشد که این میزان در زنان، متاهلین، افراد دارای تحصیلات پایین تر، بیماران ترومایی و در پایگاه های شهری بیشتر از سایرین بود. بیشترین میزان رضایتمندی مربوط به حیطه عملکرد حرفه ای و کمترین میزان مربوط به حیطه کارآیی تکنسین های بود.Introduction: One way of evaluating medical services is through assessment of patient satisfaction. Patient satisfaction is a concept that has become so important in medical care nowadays and is even more important in pre-hospital emergency. Therefore, the present study was carried out aiming to evaluate patient satisfaction from pre-hospital emergency services in cities under supervision of Arak University of Medical Sciences. Methods: In this cross-sectional study to evaluate patient satisfaction, a valid and reliable questionnaire of satisfaction scale from pre-hospital emergency care was used. The questionnaire consisted of 33 questions, 9 of which evaluated demographic data and the rest assessed satisfaction in various fields including condition of the ambulance, behavior, expertise and performance of the technicians, efficiency of care, and one question regarding the overall satisfaction with pre-hospital emergency care. Finally, gathered data were analyzed using SPSS and descriptive statistics and proper tests. Results: During the study period, 12564 missions were accomplished. The highest frequency belonged to Arak city (65%) and lowest frequency belonged to Ashtian city (9%). 366 patients participated in this study, most of which were male (59%) and had an education level less than high school diploma. In addition, most (52%) had no history of hospitalization and the number of those who were married was higher than singles (71%). The overall satisfaction score correlated with sex (p = ), marital status (p = ), education level (p = ), place of living (p = ), and history of using emergency services. Based on the results, women, those who were married, less educated people and those who had used emergency services before had reported a higher satisfaction rate. Mean satisfaction score from emergency service of Arak University of Medical Sciences was 0.7 ± 14.5 regarding condition of the ambulance, 83.7 ± 15.5 for technician behavior, 83.4 ± 15 for their expertise, 82.7 ± 14 for performance of the technicians, 89.7 ± 4 for efficiency of care, and the overall satisfaction score was 82.5 ± 14. The overall satisfaction score in cities under supervision of Arak University of Medical Sciences varied significantly (p < 0.001). Conclusion: The results of the present study showed that patient satisfaction rate from pre-hospital emergency service, was desirable. This rate was higher in women, married people, less educated people, trauma patients and in city bases compared to others. The highest satisfaction rate belonged to the professional performance and the lowest belonged to efficiency of technicians.

Antioxidant Activity of Iranian Echium amoenum Fisch & C.A. Mey Flower Decoction in Humans: A cross-sectional Before/After Clinical Trial

Medicinal plants are recognized as sources of natural antioxidants that can protect from biological system oxidative stress. The present cross-sectional before/after clinical trial was carried out to investigate the antioxidant properties of the decoction of the flowers of Echium amoenum Fisch & C.A. Mey in humans. A group of 38 healthy subjects was invited to use the E. amoenum (7 mg kg(−1)) twice daily for 14 days. Blood samples before and after entering the study were measured for lipid peroxidation level (LPO), total antioxidant capacity (TAC) and total thiol (SH) molecules. A significant reduction of blood LPO (24.65 ± 11.3 versus 19.05 ± 9.7, P = 0.029) was observed after 14 days of E. amoenum consumption. Blood TAC (1.46 ± 0.51 versus 1.70 ± 0.36, P = 0.018) and total thiol molecules (0.49 ± 0.11 versus 0.56 ± 0.12, P = 0.001) increased after 14 days of E. amoenum consumption. In conclusion, this antioxidative stress potential of E. amoenum may be due to its bioactive antioxidant components, especially rosmarinic acid and flavonoids. In recent years the importance of oxidative stress in the pathophysiology of many human disorders has been confirmed, thus use of this plant as a dietary supplement is highly recommended

Evaluating the Timing of Emergency Department Services in Hospitals of Arak City

مقدمه: بخش اورژانس یکی از مهمترین بخش های بیمارستان است که عملکرد آن می تواند تاثیر فراوانی بر کارکرد سایر بخش ها و میزان رضایت مندی بیماران داشته باشد. لذا سرعت ارائه خدمات در بخش اورژانس جهت کاستن از مرگ و میر و معلولیت ها از اهمیت ویژه ای برخوردار است. بنابراین مطالعه حاضر با هدف بررسی زمان ارائه خدمات در دو بیمارستان آموزشی شهر اراک انجام شد. روش کار: در این پژوهش مقطعی، پژوهشگران با حضور در بیمارستان های مربوطه به مدت سه ماه در شیفت های کاری مختلف، زمان ورود بیماران به بخش تریاژ را ثبت کرده و با استفاده از چک لیست مربوطه زمان های مربوط به ویزیت پزشک، ارسال نمونه های آزمایش و دریافت جواب آنها، انجام رادیوگرافی و تعیین تکلیف بیماران را با استفاده از کرونومتر ثبت کردند. يافته ها: در مطالعه حاضر 200 بیمار با میانگین سنی 5/2±8/45 وارد مطالعه شدند (5/53 درصد مرد). نتایج مطالعه نشان داد متوسط زمان تریاژ تا ویزیت پزشک، 3/4±1/8 دقیقه، فاصله ویزیت تا اولین اقدام درمانی 3/2±7/8دقیقه، زمان درخواست آزمایش تا دریافت نتیجه 5/17±9/60 دقیقه، زمان درخواست تا دریافت نتیجه رادیوگرافی 1/18±4/55 دقیقه، فاصله درخواست تا انجام نوار قلب 3/2±4/5 دقیقه و میانگین مدت زمان حضور بیمار در بخش اورژانس 3/3±9/6 ساعت می باشد. نتيجه گيری: به نظر می رسد که زمان ارایه خدمات مورد بررسی در بخش اورژانس بیمارستان های مورد مطالعه، هرچند در بعضی موارد کمتر از سایر مطالعات مشابه می باشد، اما با استانداردهای جهانی فاصله دارد.Introduction: Emergency department (ED) is one of the most important wards in a hospital and its function can deeply affect the function of other wards and patient satisfaction. Therefore, the speed of providing services in ED is of great importance in order to decrease mortality and disabilities. Thus, the present study was done with the aim of evaluating timing of services in 2 teaching hospitals in Arak. Methods: In this cross-sectional study, researchers were present in the hospitals for 3 months in various working shifts and recorded the time of the patients’ presentation to triage unit. They also recorded the times of physician’s visit, sending samples to laboratory and receiving their results, radiography performance, and decision making in a checklist using a chronometer. Results: In the present study, 200 patients with the mean age of 45.8 ± 2.5 years participated (53.5% male). The findings of the study showed that mean time interval between triage and physician’s visit was 8.1 ± 4.3 minutes, time between visit and the first treatment measure was 8.7 ± 2.3 minutes, time between ordering a test and receiving results was 60.9 ± 17.5 minutes, time between ordering radiography and getting the results was 55.4 ± 18.1 minutes, time between ordering electrocardiography and getting the results was 5.4 ± 2.3 minutes and the patient’s length of stay in ED was 6.9 ± 3.3 hours. Conclusion: It seems that although the timing of providing the studied services is less than similar studies in some cases, it is still far from the international standards.

Comparing the effect of echinacea and chlorhexidine mouthwash on the microbial flora of intubated patients admitted to the intensive care unit

Background: Providing intubated patients admitted to the intensive care units with oral healthcare is one of the main tasks of nurses in order to prevent Ventilator-Associated Pneumonia (VAP). This study aimed at comparing the effects of two mouthwash solutions (echinacea and chlorhexidine) on the oral microbial flora of patients hospitalized in the intensive care units. Materials and Methods: In this clinical trial, 70 patients aged between18 and 65 years undergoing tracheal intubation through the mouth in three hospitals in Arak, were selected using simple random sampling and were randomly divided into two groups: the intervention group and the control group. The oral health checklist was used to collect the data (before and after the intervention). The samples were obtained from the orally intubated patients and were then cultured in selective media. Afterwards, the aerobic microbial growth was investigated in all culture media. The data were analyzed using SPSS software. Results: The microbial flora in the echinacea group significantly decreased after the intervention (p < 0.0001) and it was also the case withmicrobial flora of the patients in the chlorhexidine group (p < 0.001). After 4 days, the oral microbial flora of the patients in the intervention group was lower than that of the patients in the control group (p < 0.001). Conclusions: The results showed that the echinacea solution was more effective in decreasing the oral microbial flora of patients in the intensive care unit. Given the benefits of the components of the herb Echinacea, it can be suggested as a viable alternative to chlorhexidine

An analgesic effect of Stachys lavandulifolia in patients with migraine: A double-blind randomised clinical trial study

Background and Aim: Headache is the most common clinical syndrome of pain, and it is estimated that more than half of the patients are visited by physicians due to headache. Stachys lavandulifolia is one of the medicinal herbs which are traditionally used to treat headache. Therefore, the present study aimed to investigate the therapeutic effect of this herb on pain relief among patients with migraine. Methods: In this study, 50 patients with migraine were assigned randomly by block randomisation to intervention and control groups. In addition to routine treatment, two grams of hot herbal tea was given to the intervention group twice a day and every time while control group took routine herbs and placebo. Pain intensity was measured using visual analogue scale 1 and 2 months after the beginning of treatment. The data were analysed by t-tests and repeated measures using SPSS software (Version 18.0, SPSS Inc., Chicago, USA). Results: The mean score of pain intensity was similar at baseline and after intervention reached to 4.21 ± 1.42 and 6.33 ± 1.55 for intervention and control groups, respectively. Based on the results of repeated measures, the mean score of pain intensity decreased in both groups, but the decreasing trend has more speed in intervention group. Moreover, the mean score of pain intensity decreased more 1 and 2 months after taking the medicinal herbs in intervention group compared to control group (P < 0.001). The mean score of decrease in pain intensity was statistically significant between two groups (4.21 ± 1.89 vs. 1.92 ± 1.41, P < 0.001). Conclusion: Mountain tea can be used as an auxiliary drug in the treatment of migraine patients due to its strong analgesic resources and the lack of significant side effects