Evaluation of the Effect of Nest Posture on the Sleep-wake State of Premature Infants

Background: Premature birth is a major cause of infant mortality in developed countries. Newborns confined to neonatal intensive care units (NICUs) are in a rapid stage of brain development. As such, sleep plays a pivotal role in the proper brain development of newborns. However, this developmental aspect is often disregarded due to the lack of information. Aim: This study aimed to evaluate the effect of nest posture on the sleep-wake state of premature infants. Method: This cross-over clinical trial was conducted on 60 premature infants admitted in the NICU of Ghaem Hospital in Mashhad, Iran in 2015. Infants were divided into two groups of experimental and control. Data were collected using the Assessment of Premature Infants' Behavior (APIB). Neonates in the control group were placed in an incubator, and neonates in the experimental group were positioned in a nest. Between-group comparison was performed using paired-samples T-test for normal variables and Wilcoxon test for non-normal variables. Results: In this study, no statistically significant differences were observed between the two groups in terms of the scores of deep sleep state before (P=0.50) and after the intervention (P=0.59). However, during the intervention, mean score of deep sleep was higher in the experimental group (P=0.08). Moreover, mean score of slow wake state had no significant difference between the study groups before (P=0.67), after (P=0.86), and during the intervention (P=0.81). Implications for Practice: According to the results of this study, nest posture increased the deep sleep hours of premature infants as the most imperative state of brain development. Therefore, it is recommended that nest posture be used to improve the deep sleep state of premature infants

Effect of Instructional Videos on Postoperative Respiratory Function in Patients Undergoing Off-Pump Open Heart Surgery

Background: Respiratory function in patients undergoing open heart surgery is disrupted after surgery.  Patient education on managing complications can reduce occurrence or severity of them. A variety of educational tools has been introduced, but there are controversies about the most appropriate tools. Aim: Determine the effect of instructional videos on respiratory function of the patients after off-pump open heart surgery. Method: This single-blind randomized clinical trial was conducted on 60 patients undergoing open heart surgery hospitalized at open heart surgery ward of Imam Reza (AS) hospital in Mashhad, Iran, in 2015. The patients were randomly allocated to intervention and control groups of 30 subjects. The instructional video during a 15-minute session was displayed in the intervention group and the control group educated by pamphlet and face-to-face training the day before the surgery. The respiratory function in both groups was assessed before intervention through spirometric variables including forced expiratory volume in 1 second (FEV1) and vital capacity (VC). After surgery, arterial oxygen saturation (SaO2) and PaO2/FiO2 Ratio (PF ratio) were measured 30 minutes after extubation, as well as the variables of FEV1, VC, SaO2 and PF ratio 24 hours after extubation. Data were analyzed by independent t-test, Mann-Whitney, Chi square, paired t-test, Wilcoxon and Friedman using SPSS version 11.5 software. Results: The means age of patients were 57.5±4.8 and 56.2±4.2 years in the intervention and the control groups, respectively. The difference of the PF ratio 24 hours after extubation compared to 30 minutes after extubation in the intervention group was significantly higher than the control group (

The Effect of Mother Empowerment Program on Mothers’ Attachment to their Hospitalized Premature Neonates

Background: Birth of a premature neonate is associated with hospital admission and separation from the family. Admission of the neonates intervenes on infant-mother attachment and so adversely affects on the quality of care given by the mother, and subsequently increases the risk of delayed behavioral problems in the children. Aim: To assess the effectiveness of mother empowerment program on the premature infant-mother attachment. Methods: In this randomized clinical trial, 70 mothers of premature infants, admitted to the neonatal intensive care unit (NICU) of Omolbanin hospital of Mashhad in 2014, were divided into of intervention and control groups. The Empowerment program was a multi-step treatment program, in which information about the premature infants was provided to mothers through an illustrated booklet with a workbook and audio file in each step. Mothers in the control group received information and routine care according to the hospital guideline. The mother-infant attachment was measured after the intervention using the maternal and neonatal behaviors Avant tool. Data analysis was performed using chi-square and t-student tests by SPSS software version 11.5. Results:The mean scores of maternal attachment behaviors after the intervention in the empowerment and control groups were (56.62±8.06) and (39.51±7.77), respectively; the difference between the groups was statistically significant (

The Effect of Group Counseling on Physiological Aspect of Self-care and HbA1C Level of Patients with Diabetes Type II

Background: The most important underlying cause of death in diabetic patients is poor self-care. The effect of education on self-care promotion has been widely investigated; however, the advisory role and impact of the treatment team have been scarcely investigated.  Aim: Determining the effect of group counseling on the psychological aspect of self-care and level of glycosylated hemoglobin in the patients with diabetes type II. Methods: In a randomized clinical trial, 73 patients with type II diabetes mellitus, who had been referred to Parsian Diabetes clinic of Mashhad in 2014, were divided into two groups of intervention and control. The group counseling program was performed in five 1.5-hour sessions with 3-day intervals, and each groups consisted of 8 to 10 people. The content of the meetings was problems in nutrition, exercise, diabetes mellitus disease, diabetes-related mental health problems, diabetes medications, and self-control of blood glucose. Researcher-made diabetes care questionnaire was filled and HbA1c test was measured before and two months after the intervention. Data were analyzed by SPSS version 11.5 using paired sample and independent t-tests. Results: In this study,27.3 percent of the subjects were male and 72.7 were female with the mean age of 49.1 ± 8.3. The scores of physiological aspect of self-care and HbA1C of the diabetic patients before the intervention was not significantly different between the groups; but in the post-intervention phase, the self-care in intervention group (49.1±5.8) significantly increased compared to the control group (31.8±12.2) (

Effects of Motor Development Stimulation on Anthropometric Indices of Infants Aged 1-12 Months in Foster Care Homes

Background: The first three years of life have a pivotal role in growth and development of infants. Extra-uterine environment largely affects brain development of infants during the first year of life.However,no specific programs are available for brain development stimulation in foster homes. Aim: This study aimed to evaluate the effects of motor development stimulation package on anthropometric indices of infants staying in foster homes. Method: This experimental study was conducted on 50 infants aged 1-12 months at Ali Asghar foster home of Mashhad, Iran in 2013. Infants were randomly divided into two groups of intervention (n=25) and control (n=25). Motor development stimulation packages were used for intervention group three times a week for eight consecutive weeks (24 sessions, two hours each). Anthropometric indices of infants were evaluated using standard instruments before and after intervention. Data analysis was performed in SPSS V.11.5 using independent T-test and Mann-Whitney U test. Results: In this study, mean age of infants in intervention and control groups was 6.04±3.48 and 4.3±3.70 months, respectively. In total, 68% of infants were male, and 32% were female. After intervention, Mann-Whitney test results showed no statistically significant difference in height (P=0.47) and head circumference (P=0.11) of infants between the groups. However, independent T-test showed a statistically significant difference in body weight of infants (P=0.007) between the groups after intervention with the stimulation care package. Implications for Practice: According to the results of this study, use of evidence-based motor development stimulation package for eight weeks resulted in increased weight of infants, while it had no effect on height and head circumference. Therefore, it is recommended that complementary studies be conducted in this regard