40 research outputs found
Clinical Features of Patients with Probable 2019 Novel Coronavirus Infected Pneumonia in Rasht, Iran: A Retrospective Case Series
BACKGROUND: Coronavirus disease-19 (COVID-19) is the first pandemic infectious disease caused by a novel coronavirus. Viral pneumonia is a severe complication of COVID-19.
AIM: Due to the high prevalence of this disease globally, especially in Iran, the aim of this study was to determine the clinical features of seven patients with probable COVID-19 infected pneumonia in Rasht, North Iran.
MATERIALS AND METHODS: In this retrospective case series study, we described the clinical, laboratory, and radiological features of seven patients with probable COVID-19 infected pneumonia at Razi Hospital, Rasht, north of Iran, from February 27 to March 16, 2020.
RESULTS: In this study, the most common clinical symptoms during hospitalization in patients with COVID-19 were poor appetite (seven cases), dehydration (seven cases), cough (six cases), dyspnea (six cases), fatigue (six cases), fever above 38°C (five cases), myalgia (five cases), Chills (five cases), feeling fever (five cases), sore throat (five cases), and nausea (five cases), respectively. The average body temperature in these patients was 39.32°C. In laboratory findings, erythrocyte sedimentation rate was elevated in three patients. Contrary to most of the evidence, C-reactive protein was not elevated in five patients. All patients received antibiotic and antiviral medications and received symptomatic treatment. Finally, four patients responded to the treatments and were discharged from the hospital; two patients were still hospitalized and only one patient died.
CONCLUSION: Patients with COVID-19 associated pneumonia can be treated by evaluating and implementing appropriate therapeutic management. However, at the moment the disease progression for patients with COVID-19 cannot be accurately predicted
The Effect of Preoperative Oral Melatonin on Postoperative Pain after Lumbar Disc Surgery: A Double-Blinded Randomized Clinical Trial
BACKGROUND: Despite advances in surgical and anesthesiology techniques, many patients continue to experience postoperative pain after lumbar disc surgeries. The aim of this study was to investigate the effect of preoperative oral melatonin on the severity of postoperative pain after lumbar laminectomy/discectomy.
METHODS: In this double blinded randomized controlled clinical trial 80 patients undergoing an elective mini-open microdiscectomy surgery at Imam Khomeini educational hospital in Sari, Iran, were selected and randomly assigned into one of four groups. Patients in group A, B, C, and D received 3, 5 and 10 mg melatonin or placebo tablets one hour before surgery, respectively. Using the visual analogue scale (VAS) the severity of pain, nausea and vomiting, pruritus, and use of narcotics were assessed immediately after surgery and before leaving the post-anesthesia care unit, 6, 12 and 24 hours postoperatively.
RESULTS: In all three groups receiving melatonin at all three different doses, postoperative pain was significantly less than the placebo group (P<0.01). There were no statistically significant differences in postoperative pain level between the three groups receiving melatonin (P>0.05). The amount of opioid received by the patients within 24 hours after surgery had statistically significant differences within the groups (P=0.043, F=2.58). The results of post hoc analysis in terms of postoperative pain intensity showed statistically significant differences between the two groups receiving melatonin at a dose of 5 mg and the placebo group (P= 0.04). No serious side effects reported in four groups.
CONCLUSION: The use of oral melatonin with a dose of 5 mg, 1 hour before the surgery as an inexpensive method can effectively reduce pain intensity as well as the amount opioid use after lumbar laminectomy and discectomy
A Cross-Sectional Study Examining the Correlation between Nocturnal Melatonin Level and Sleep Quality in Patients Admitted To the Cardiac Care Unit
BACKGROUND: Quality of sleep, as a basic need, is an important factor for surviving patients in hospitals. Many factors may contribute to disturbing patients sleep, such as continuous ambient light, is required for healthcare providers to monitor patients. Ambient light can influence patients' quality of sleep due to melatonin secretion.
AIM: Study aimed to determine the correlation between nocturnal melatonin levels and sleep quality in patients admitted to the Cardiac Care Units (CCU).
MATERIAL AND METHODS: This cross-sectional study was done on inpatients of CCUs at Amir-Almomenin Hospital in Kordkoy city, a cardiac referral hospital in the northeastern of Iran in 2015. Sixty-eight inpatients were selected through convenience sampling. Before data gathering light level of CCUs was measured every one hour in 2 days, the quality of nocturnal sleep was investigated through Verran and Snyder-Halpern (VSH) Sleep Scale at the second night of admission urinary melatonin level was measured at the same night in all urine excreted between 22:00 pm and 07:00 am.
RESULTS: The mean and standard deviation (SD) score of sleep quality in three dimensions of sleep disturbance, sleep effectiveness and sleep supplementation were 336.6 ± 149.9, 269.0 ± 82.2, and 175.2 ± 30.7, respectively. Also, the mean and SD of nocturnal urinary melatonin levels was 323.02 ± 136.21 pg/ml. There was not a significant correlation between level of nocturnal melatonin and three domains of sleep quality; sleep disturbance (r = 0.005, P = 0.968), sleep effectiveness (r = 0.090, P = 0.464), and sleep supplementation (r = -0.037, P = 0.763).
CONCLUSION: According to the result, most CCUs patients suffer from sleep disturbance. However, there was no correlation between the level of melatonin and sleep quality. There is a need for recognising the reasons for sleep disturbances in Cardiac Care Units. It is imperative for care providers to be able to recognise the causes of sleep disturbances and to modify environmental factors such as ambient light to improve sleep quality in hospitalised patients
Barriers to and Facilitators of Research Utilization among Iranian Nurses: a Literature Review
Introduction: Research utilization (RU), is an important strategy to promote the
quality of patient care. The aim of this study was to present a comprehensive literature
review describing barriers and facilitators of RU among Iranian nurses.
Methods: Literature review was undertaken using the international databases including
Pub Med/Medline, Scopus, Science Direct, and Google Scholar. Also, Persian
electronic databases such as Magiran, SID and Iran Medex were searched up to May
2014. The search was limited to articles in the English and Persian languages that
evaluate the barriers or facilitators of RU among Iranian nurses.
Results: A total of 11 articles were in the final dataset. The most important barriers to
RU among Iranian nurses were related to the organization factors such as inadequate
facilities; insufficient time on the job, lack of authority, physician cooperation, and
administrative support. The most frequent facilitators of RU were education in
enhancing nurses knowledge and skills in research evaluation, support from
knowledgeable nursing colleagues and nursing faculty in the clinical setting, access to
an expert committee for clinical appraisal, improving skills in English language and
searching for articles, sufficient economic resources to carry out research, and having
access to more facilities such as internet.
Conclusion: Iranian nurses encounter with the same difficulties as to other countries
regarding RU; while setting related barriers were the predominant obstacles to RU
among them. Therefore, health managers are expected to plan appropriate strategies to
smooth the progress of RU by nurses in their practice
The Missing Position in Practice: A Neglected Issue in Community Health Nursing in Iran
Global social and economic changes have not only led to substantial increases in elderly populations but also the manifestation of numerous degenerative and chronic diseases, and new patterns of disease caused by occupational hazards, environmental pollution and accidents.1,2 Today, public health concerns related to quality care, cost of medical services and low access to health care centers have led to a shift in the paradigm of healthcare from the traditional care settings to community centers.1
With regards to the same points, the health systems in a society must acquire the capabilities required for better meeting the ever-growing demands resulting from these changes.3 In order to meet these increasing needs and to raise the overall healthcare level of its communities, the Islamic Republic of Iran has envisioned short- and long-term plans within the framework of the 2025 Horizon Plan in various fields of research, education and provision of healthcare services.4 In line with this aim, the office of the High Commissioner for medical planning in the country has recently revised the educational curriculum for the Master’s course of community health nursing and has drawn outlines in order to focus the career position of their graduates on a community-oriented approach, in places such as healthcare centers, hospitals, rehabilitation centers, schools, addiction treatment centers, emergency services and natural disaster committees, and in all other organizations needing the services of community health nurses.
Moreover, according to the vision drawn out in this plan, in the next ten years (by 2025) the graduates of community health nursing must be able not only to meet the changing needs of Iranian society, but also clearly attain regional and global standards in nursing education and offer effectual service to all members of the society.5 In addition, in most countries of the world, keeping such curriculum visions in mind, curriculum designers facilitate the career position of community health nurses so that they can give care to individuals, families and communities. Furthermore, the number of these nurses working outside the hospital in the community at large has increased substantially, and the community is called their clients.1
While in Iran, community health nurses after graduating with Master’s degree are in practice faced with an absence of specifically defined job positions even though the curriculum has designated the correct future occupational status. Therefore, Iranian community health nurses are mostly forced into employment in clinical settings or educational centers and do not have the ability like their counterparts in other countries to find a job and start serving at health centers which, as mentioned above, are predetermined before graduation.6
Now, in view of the above mentioned points, considering the absence of suitable tools for directing these community health nurses to their appropriate occupational and professional positions, this question arises that to what extent the devised long-term objectives (Horizon 2025) of the Islamic Republic can be achieved. It is recommended that the present process of employing community health nurses should be revised so that it facilitates their real occupational and professional positions resulting in providing better services to their clients
Patient education among nurses: bringing evidence into clinical applicability in Iran
The aim of this study was to present acomprehensive review of the literatures describingbarriers and facilitators of patient education (PE)perceived by Iranian nurses in order to explainclinical applicability of patient education. Methods.Review of the literature was undertaken using theinternational databases including PubMed/Medline,Scopus, ScienceDirect, as well as Google Scholar. Also,Persian electronic databases such as Magiran, SID andIranMedex were searched. Electronic databases weresearched up from conception to September 2014 usingsearch terms: “patient education”, “ patients education”,“patient teaching”, “patient training”, “nurse”, “nurses”, “ nursing”, “ and “Iran”. Only studies wereincluded that were related to barriers and facilitatorsof PE among Iranian nurses. Results. Twenty-sevenstudies were included. The main influential barrierswere categorized into three major areas: 1) Nurserelatedfactors: nursing shortage 2) Administrationrelatedfactors: unsupportive organizational culture, and3) Patient-related factors: low compliance. The mostperceived facilitators were recognized as “increasing,selecting and training special nurses for providing PE”and “providing PE courses for nurses and appropriatefacilities for PE”. Conclusion. Iranian nurses encounterbarriers in PE, and the most frequently encounteredbarriers were related to administration factors. Thesefindings have implications for administrators andmanagers in health settings. In order to promotePE among nurses, administrators should create asupportive environment and use effective strategies tosmooth the progress of PE by nurses in their practice inorder to ensure optimal outcomes for patients.Objetivo. Identificar as barreiras e facilitadores da
educação do paciente (EP) percebida pelas enfermeiras
iranianas com o fim de explicar a aplicabilidade
clínica da educação ao paciente. Métodos. Revisão
da literatura que se levou a cabo utilizando as bases
de dados internacionais PubMed-Medline, Scopus,
ScienceDirect e Google Scholar. Ademais, se realizaram
buscas nas bases de dados electrónicas persas Magiran,
SID e IranMedex. Se realizaram buscas desde a criação
das bases de dados até setembro de 2014 usando os
termos de busca: “educação do paciente”, “educação de
pacientes”, “ensinamento do paciente”, “treinamento
do paciente”, “enfermeira”, “enfermeiras”, e “Irã”. Só
se analisaram os estudos relacionados com as barreiras
e facilitadores de EP entre enfermeiras iranianas.
Resultados. Se incluíram 27 estudos. As principais
barreiras foram classificadas em três grandes áreas:
1) Fatores relacionados com a enfermagem: escassez
deste recurso humano, 2) Fatores relacionados com a
administração: inapropriada cultura organizacional y 3)
Fatores relacionados o paciente: baixo cumprimento.
Os facilitadores mais percebidos foram reconhecidos
como “o aumento, a seleção e formação especial das
enfermeiras para proporcionar EP” e “disponibilidade
de cursos de EP para as enfermeiras e a disponibilidade
de instalações adequadas brindar o EP”. Conclusão. As
enfermeiras iranianas encontram barreiras na EP, sendo
as mais frequentes as relacionadas com fatores da
gestão dos recursos. Estes resultados têm implicações
para os administradores e diretivos das instituições
de saúde, pois para promover que as enfermeiras em
sua prática brindem a EP, se deve criar um ambiente
de apoio e utilizar estratégias eficazes com o fim de
garantir resultados ótimos nos pacientes.Objetivo. Identificar las barreras y facilitadores de
la Educación del Paciente (EP) percibida por las enfermeras iraníes con el fin de explicar la aplicabilidad
clínica de la educación al paciente. Métodos. Revisión
de la literatura que se llevó a cabo utilizando las bases
de datos internacionales PubMed-Medline, Scopus,
ScienceDirect y Google Scholar. Además, se realizaron
búsquedas en las bases de datos electrónicas
persas Magiran, SID e IranMedex. Se realizaron
búsquedas desde la creación de las bases de datos
hasta septiembre de 2014 usando los términos de
búsqueda: “educación del paciente”, “educación de
pacientes”, “enseñanza del paciente”, “entrenamiento
del paciente”, “enfermera”, “enfermeras”, e “Irán”.
Solo se analizaron los estudios relacionados con las
barreras y facilitadores de EP entre enfermeras iraníes.
Resultados. Se incluyeron 27 estudios. Las principales
barreras se clasificaron en tres grandes áreas: 1)
Factores relacionados con la enfermería: escasez de
este recurso humano, 2) Factores relacionados con la
administración: inapropiada cultura organizacional y 3)
Factores relacionados el paciente: bajo cumplimiento.
Los facilitadores más percibidos se reconocieron como
“el aumento, la selección y formación especial de las
enfermeras para proporcionar EP” y “disponibilidad de
cursos de EP para las enfermeras y la disponibilidad
de instalaciones adecuadas para brindar el EP”.
Conclusión. Las enfermeras iraníes encuentran barreras
en la EP, siendo las más frecuentes las relacionadas con
factores de la gestión de los recursos. Estos resultados
tienen implicaciones para los administradores y
directivos de las instituciones de salud, pues para
promover que las enfermeras en su práctica brinden
la EP, se debe crear un ambiente de apoyo y utilizar
estrategias eficaces con el fin de garantizar resultados
óptimos en los pacientes
Patient education among nurses: bringing evidence into clinical applicability in Iran
Objective.The aim of this study was to present a comprehensive review of the literatures describing barriers and facilitators of patient education (PE) perceived by Iranian nurses in order to explain clinical applicability of patient education. Methods. Review of the literature was undertaken using the international databases including PubMed/Medline, Scopus, ScienceDirect, as well as Google Scholar. Also, Persian electronic databases such as Magiran, SID and IranMedex were searched. Electronic databases were searched up from conception to September 2014 using search terms: "patient education", " patients education", "patient teaching", "patient training", "nurse", " nurses", " nursing", " and "Iran". Only studies were included that were related to barriers and facilitators of PE among Iranian nurses. Results. Twenty-seven studies were included. The main influential barriers were categorized into three major areas: 1) Nurse-related factors: nursing shortage 2) Administration-related factors: unsupportive organizational culture, and 3) Patient-related factors: low compliance. The most perceived facilitators were recognized as "increasing, selecting and training special nurses for providing PE" and "providing PE courses for nurses and appropriate facilities for PE". Conclusion. Iranian nurses encounter barriers in PE, and the most frequently encountered barriers were related to administration factors. These findings have implications for administrators and managers in health settings. In order to promote PE among nurses, administrators should create a supportive environment and use effective strategies to smooth the progress of PE by nurses in their practice in order to ensure optimal outcomes for patients