Journal of Research Development in Nursing and Midwifery

The effect of lavender oil inhalation on anxiety and some physiological parameters of open- heart surgery patients

Seyyed Abedin

Background and Objective: surgery is a stressful experience and in open heart surgery, the patients are greatly faced with anxiety, which has been reduced by different approaches. This study aimed to investigate the effects of aromatherapy on anxiety level.

Material and Methods: This blinded- randomized- controlled clinical trial was carried out on 90 patients divided into two groups of intervention and control. the patients of intervention group were asked to inhale two drops of lavender essential oil and those of control group two drops of distilled water poured on a gauze , for 20 minutes. In addition to measuring patients’ anxiety level by Spielberger questionnaire, we recorded their vital signs. Using SPSS 16 software, the data was described via mean, standard deviation and percent, and analyzed by using independent t-test, paired t-test, Chi Square and Covariance (0.05).

Results: The mean age of intervention group was 50.49 ± 10.92 and control group was 50.13 ± 9.20. Anxiety score in intervention group was significantly decreased from 56.37±5.6 to 54.73±5.42 and in control group meaningfully reduced from 55.18±7.35 to 54.0±7.22 (p<0.05). The mean anxiety score in the intervention group was significantly higher than that of control group (p<0.05).

Conclusion: Because anxiety reduction in aromatherapy group was more than control group it can be concluded that aromatherapy with lavender essential oil have significant effect in reducing anxiety and therefore can be used in clinical situations.

Effect of the Individual Multi- Stage Care on the Treatment Adherence among Hemodialysis Patients

GholamReza Mahmoodi

Background and Objective: Treatment adherence has an essential role in improving quality of life, survival, decreasing cost and side effects of treatment in patients underwent hemodialysis. This study aimed to determine the effect of individual multi-stage care on the treatment adherence in hemodialysis' patients, ShahrekordHajar hospital.

Material and Methods: This clinical trial was conducted on 66 Hemodialysis patients in 2013. They were randomly allocated into two equal groups of intervention and control. The instrument was the end-stage renal disease adherence questionnaire (ESRD-AQ). The patients in intervention group were participated in 8-session individual care program for one hour in addition to routine treatment. The data was analyzed using Mann–Whitney , Wilcoxon and Spearman (P<0.05). Level.

Results: The study indicated a significant difference between two groups in all dimensions of treatment adherence except dietary and food adherence. Adherence to treatment was better in intervention group (P<0.05). Furthermore, there was a significant correlation between adherence treatment and age of patients (P<0.05, r=0.245).

Conclusion: based on the findings, multi-stage care is effective on different aspects of treatment adherence.

The Effect of Open and Closed Endotracheal Tube Suctioning System on Cardio- respiratory Parameters of Infants Undergoing Mechanical Ventilation

Narges Asgari

Background and Objective: Mechanical ventilation is used for some infants in neonatal intensive care unit (NICU) due to many physiological and clinical causes. The practice of endotracheal suctioning of ventilator- treated patients is necessary to remove secretions to prevent obstruction of the endotracheal tube and lower airways. This study aimed at determining the effect of open and closed suctioning methods on cardio-respiratory parameters of infants undergoing mechanical ventilation.

Material and Methods: In this clinical trail, forty-four infants underwent mechanical ventilation in NICU were selected by simple continuous sampling. The samples were randomly divided into two groups. In the first group: first, open suctioning and then after three hours of cleaning, closed suctioning was performed. In the second group, first closed suctioning and after three hours of cleaning, open suctioning was implemented. Respiratory rate (RR), oxygen saturation, pulse rate and blood pressure were assessed before ( in three, two and one minutes ) , during and after ( in one , two and three minutes ) each type of suctioning. The Data was analyzed by Software SPSS-16 using ANOVA with repeated measures and independent t-test.

Results: There was a significant difference between mean respiratory rate and oxygen saturation in infants during and after the closed and open suctioning (p<0.05). Oxygen saturation had a significant reduction in open method compared to closed method during and immediately after suctioning. Respiratory rate had a significant reduction in 3 minutes after open suctioning in both steps. The mean of diastolic pressure in second step of open method and in both steps of closed method was significant (p<0.05). There was a significant difference between the mean pulse rate in different times of open suctioning in the first step (p<0.05), Pulse rate drop significantly was lower in closed suction than open one (p<0.05).

Conclusion: because of little changes caused by closed suctioning in hemodynamic condition, it is recommended using the closed suctioning to prevent from respiratory complications and pulse rate dropping in infants.

The Effect of B‌erberis Vulgaris Extract on Blood Pressure and Weight of the Patients suffered from Non-alcoholic Fatty Liver Disease

Hamzeh SalehZadeh

Background and Objective: Hypertension in patients with non-alcoholic fatty liver disease is the main cause of cardiovascular disease . The present study aimed to determine the effect of Berberis vulgaris fruit extract on blood pressure and weight in patients with non-alcoholic fatty liver disease.

Material and Methods: This clinical trial was conducted in 2011 on 80 patients with non-alcoholic fatty liver disorder, including 32 males (40%) and 48 females (60%), who were randomly assigned into case and control group. The case group were given two capsules (750 mg) including berberis vulgaris extract every day for three months, while the subjects of control group treated by placebo. Blood pressure and weight of baseline and those of after three month were assessed and analyzed by SPSS software Ver.17, using paired t-test and independent t-test (p≤0.05).

Results: the mean of weight decreased from 80.23±11.68 (baseline) to 78.71±11.31 (End of the third month), which was statistically significant compared to control group (P<0.001). The Mean of systolic and diastolic blood pressure was significant compared to control group. (p<0.05).

Conclusion: Considering the significant decrease in weight and blood pressure, further studies with larger sample size are needed to generalize crucially the results. This extract can be introduced to treat overweight and hypertension in patients with non-alcoholic fatty liver disease.

Evaluation of Detoxified Addicts’ Life Quality Participating in Narcotics Anonymous, Therapeutic Community and who Refer to Methadone Therapy Clinics in Mashhad, 2012

Ali Tallaei

Background and Objective: Substance abuse is a universal problem. Iranian Addicts, on average, spend 15 percent of the oil revenue on drugs. Addiction is the cause of crisis and decreased quality of life. The Nurse can support care- giver to select the effective method. The purpose was to compare detoxified addicts’ life quality participating in narcotics anonymous, therapeutic community and who refer to methadone therapy clinics in Mashhad, Iran.
Material and Methods: This three-group pretest-posttest study was conducted on the subjects , selected via convenience sampling, including 27 patients in narcotics anonymous, 27 in therapeutic community and 23in methadone treatment. The baseline and after 1.5 months data were collected, using a questionnaire, and analyzed by SPSS software.

Results: the results show that participating in the sessions of all groups led to increased quality of life. In all eight aspects of program, the scores of Narcotics Anonymous group were significantly higher than those of other groups.

Conclusion: because of significant effect on quality of life, we recommend applying these approaches, especially Narcotics Anonymous.

The Effect of Acupressure on the Fatigue of Patients with Cancer: A Randomized Clinical Trial

Mahnaz Khatiban

Background and Objective: The Fatigue related to cancer is one of the common problems of both patients and care-givers. Nowadays, acupressure as a complementary medicine has become more common in patients with cancer for balancing and improving body energy. This study aimed to assess the effect of acupressure on the fatigue of patients with cancer.

Material and Methods: This blinded- randomized clinical trial was conducted on 85 patients with cancer in hematology ward of Beheshti hospital of Hamadan. The subjects were located in three groups of intervention, sham and control. First, the fatigue level was measured by Brief Fatigue Inventory (BFI) as a baseline. Then, real acupressure in intervention group and unreal acupressure in sham group was performed for 10 days and only routine cares were given in control group. The fatigue amount was measured on the fifth and tenth days. The Data was analyzed by SPSS software version 16, using paired T- test and repeated measurements.

Results: Acupressure was effective on the fatigue of patients with cancer (p<0.001). However, conducting unreal acupressure in sham group was effective as well (p<0.01), but the routine cares in control group was not effective and even in some cases led to increased fatigue.

Conclusion: Acupressure can be used as a complementary therapy to decrease the fatigue in the patients with cancer considering its low cost, safety and simplicity.

Effect of Cinnamon on Lipid Profile, Liver Enzymes, Insulin Resistance and hs -CRP Inflammatory Factor in Patients with Nonalcoholic Fatty Liver Disease

Azita Hekmat Doost

Background and Objective: Non-alcoholic fatty liver disease is the most prevalent cause of hepatic related problems. , which has not been introduced any crucial treatment for it so far. Insulin resistance and oxidative stress are the most important risk factors for this disease. As anti-oxidant and insulin resistance decreasing effect of Cinnamon has been shown in prior studies, we carried out this research to determine the effect of cinnamon on lipid profile, liver enzymes, insulin resistance and hs-CRP inflammatory factor in patients with nonalcoholic fatty liver.

Material and Methods: this clinical trial was conducted on 50 patients with fatty liver, selected on the basis of including criteria. The Intervention group was given 1.5 gram Cinnamon and placebo group taken placebo for 12 weeks. Lipid profile (triglycerides, total cholesterol, HDL and LDL), fasting blood glucose, serum insulin , hs - CRP inflammatory factor, liver enzymes (ALT and AST and GGT), insulin resistance index (HOMA-IR) and insulin sensitivity (QUICKI), diet, physical activity and anthropometric indices were measured in the beginning and end of the study. Statistical analysis was performed by SPSS software, using Covariance, Students t-test, Paired t-test, Wilcoxon and Mann-Whitney.

Results: A significant decrease in HOMA, fasting blood glucose, total cholesterol, ALT, AST, GGT and hs-CRP , and a significant increase in Quicki were seen in Cinnamon group (p <0.05). The change of LDL cholesterol in both groups was significant (p <0.05), whereas the reduction of HDL cholesterol wasn’t significant (p=0.130).

Conclusion: based on the results, the use of Cinnamon may be effective in the patients with non-alcoholic fatty liver disease.

Effects of Therapeutic Touch Plane on Acute Induced-Nausea in Breast Cancer Women in Isfahan 2012-13

Zohreh Vanaki

Background and Objective: Nausea is the worst, prevalent chemotherapy- induced complication. The purpose of this research is to investigate the effect of therapeutic touch plan on chemotherapy- induced nausea in breast cancer women in Isfahan, 2012-2013.

Material and Methods: this quasi-experimental clinical trial was conducted in 2012 -2013 on three groups of intervention, placebo and control. The intervention was the therapeutic touch applying on the breast of the women undergone chemotherapy with the same medicine regiment. The data related to the times of nausea was recorded four times in a day by a checklist and analyzed by SPSS-16, using ANOVA & Kruskal–Wallis.

Results: the Findings showed that the therapeutic touch was significantly effective than control and placebo in reducing the duration of nausea. On the effect of suggestion, the times of nausea were diminished in both intervention and placebo. The onset of nausea was delayed in intervention compared to placebo and control.

Conclusion: owing to the effect on acute chemotherapy- induced nausea, it is recommended that therapeutic touch program be educated and implemented by clinical nurses.

The Pressure on the SanYinJiao and Hugo on the Duration of the First and Second Stage of Labor

Rafat KazemZadeh

Background and Objective: One of the problems that the women are faced with is prolonged labor, leading to high possibility of infection, hypoxia, physical, neural damage and death of fetus and neonate, newborn death, postpartum hemorrhage, increased maternal insomnia and fatigue. This research aimed at determining the effects of acupressure on Sanyinjiao - Hegu points in nulliparous women.

Material and Methods: This double blinded-randomized clinical trial was conducted on 84 nulliparous referring to the hospitals in Ardabil, 2012. The subjects were randomly allocated to intervention and control group. The intervention was the pressure applying on Sanyinjiao - Hegu points in different dilatations. The Length of the first and second stage was recorded by vaginal exam and the data was analyzed by f SPSS- 16, using Chi-Square and independent t- test.

Results: the mean of active phase in intervention group (2:15±1:19 hour) compared to control group (4:10±1:59 hour) was decreased (p=0.001). The length of second stage in intervention group (00:45 ± oo: 25 minute) in comparison with control group (1:04 ± 00:39 hour) was reduced (p=0.008).

Conclusion: Acupressure on sanyinjiao-hegu points resulted in shortening the length of active phase and second stage of delivery. Because of being simple, inexpensive, safe and acceptable for clients, it can be used in training and clinical practice of midwifery students.

The effect of Intravenous and Oral Ascorbic Acid Consumption on Anemia in Hemodialysis Patients

Mohammad Mojerloo

Background and Objective: anemia is one of the main problems of chronic renal failure patients undergone Hemodialysis and erythropoietin is not effective for these patients. Since Vitamin C deficiency in Hemodialysis patients is common, this study was performed to compare the effect of intravenous and oral ascorbic acid consumption on anemia in Hemodialysis patients.

Material and Methods: this clinical trial was conducted on 75 patients, selected via convenience sampling and including criteria (hemoglobin, 11mg/dl ferritin, 100ug/L transferring saturation, < 20%). The subjects were randomly assigned to three equal groups of control , oral ascorbic acid (POAA) and intravenous ascorbic acid (IVAA) After each every-other-day dialysis performed for eight weeks, the patients of IVAA group were given 300mg intravenous vitamin C and the ones of POAA group given 500mg vitamin C orally. The Plasma iron with chemical method, total iron-binding capacity (TIBC) and ferritin level with indirect method, hemoglobin with cell counter and transferring saturation (TSAT) with related formula were measured. Using a checklist, the data of demographic, laboratory results and side effects were recorded and analyzed by SPSS-13, using ANOVA and scheffe post-hoc test (p≤ 0.05).

Results: the baseline hemoglobin, serum iron, ferritin, TIBC and TSAT in three groups were not different significantly. After intervention, the hemoglobin level of IVAA group( 20.1g/dl ) and in POAA group (0.99g/dl) were increased compared to control group(P>0.001). the mean of hemoglobin in IVAA was significantly more than POAA (P>0.05).

Conclusion: based on the results, the use of oral and intravenous vitamin C can be effective in the anemia caused by iron deficiency, especially vitamin C injection that is more beneficial.

The Effect of Red Clover on Severity of Physical Menopause Symptoms

Simin Tavoni

Background and Objective: nowadays, many menopausal women seek complementary and alternative drugs to relieve intensity of menopause symptoms. Most researchers are interested in studying medicinal plants containing isoflavones such as Red Clover with estrogen like properties. This study was conducted to determine the effect of red clover on the severity of physical menopause symptoms.

Material and Methods: This randomized clinical trial was conducted on 72 menopausal women aged 50-59 in 2012. The participants of intervention group daily received two capsules containing 40 mg red clover for two months while the control ones received two capsules containing 40 mg starch in the same way. The data of baseline and the one of after two months were collected by demographic questionnaire and physical dimension of Menopausal Rating Scale and analyzed by SPSS version 14, using Man-Whitney and Student-t test.

Results: Based on the mean and SD of physical menopause symptoms, the severity of flushing, nocturnal sweating and heart discomfort was reduced significantly compared to control group. Furthermore, all physical menopause symptoms were remarkably diminished (P<0.05).

Conclusion: in accordance with the results, the capsule of red clover can be helpful in mitigating the severity of physical menopausal symptoms.

The Effect of Massage Therapy on Glycemic Control (FBS, HBA1C) in Women with Diabetes Type 2

Mahboobeh Ghasemi Pour

Background and Objective: Type 2 diabetes is a major public health problem with increasing morbidity and mortality. Complementary therapies are widely used by the people with diabetes. Massage therapy (MT) is an increasingly popular complementary therapy. Since few studies have been conducted on the effect of MT on people with diabetes, we aimed to investigate the effect of massage therapy on glycemic control (FBS, HBA1C) in women with diabetes.

Material and Methods: this clinical trial was conducted on fifty women with type 2 diabetes selected by convenience sampling and placed randomly in treatment and control groups. The test group received 30 mins-long massage therapies in a week (10 sessions) and the control group received just standard care. Glycemic control indices including HbA1C, FBS were measured at baseline, after 10 weeks of therapy and then analyzed by paired-t test and MANOVA (p≤ 0.05) .

Results: the mean and standard deviation of HBA1C of massage group (7.18±0.14) was significantly (P < 0.01) different from control (8.06±0.22) and the difference of FBS in massage group (1.46±5.28) from control (1.6±4.87) was meaningful statistically (P < 0.05).

Conclusion: accordingly, massage therapy can be useful for glycemic control (FBS, HBA1C) in women with type 2 diabetes.

Evaluation of Temperament–based Diet Education on Frequency of the Symptoms in Patients with Gastroesophageal Reflux Disease (GERD)

Khadijeh Harati

Background and Objective: Gastroesophageal reflux disease is one of the most common chronic disorders of the digestive system. The most common reason for this complaint is the unfitted temperament of food and body. This study aimed to determine the effect of temperament–based diet education on quality of life in the patients with GERD in endoscopy department of Qaem hospital in Mashhad. .
Material and Methods: This randomized-controlled clinical trial was conducted on 60 patients, referring to Qaem hospital, were randomly assigned to two groups of diet education and control. The intervention was a two-week long diet education class, which was on the basis of temperament. The instruments were the frequency Scale for the symptoms of gastro esophageal reflux ) FSSG) and the diet checklist. The data was analyzed by SPSS-11.5, using Chi Square, Independent T test, Paired T test.

Results: After education, the frequency of the symptoms was significantly reduced (p<0.0001). The mean score in education group compared to control was diminished both shortly after intervention (13.63±4.77, p<0.001 ) and after two weeks (18.73±4.15, p=0.070) .

Conclusion: Considering temperament in the diet education by nurses can play an important role in decreasing the frequency of symptoms in patients with Gastro esophageal Reflux Disease.

The Effect of Deep Breathing Exercise on arterial blood gases after coronary artery bypass Graftingg(CABG)

Hiva Mohammadi BolbolanAbad

Background and Objective: After coronary artery bypass surgery, pulmonary complications and oxygenation disorders are common, which have an important role in disablement and mortality. Different methods are used for improvement of pulmonary function and oxygenation. In this study we aimed at evaluating the effect of deep breathing exercise on arterial blood gases after CABG.

Material and methods: This clinical trial was conducted on fifty patients who had CABG in Chamran hospital and Sina heart center of Isfahan, 2012. The patients were randomly located in groups of intervention and control. The intervention was the use of deep breathing exercises initiated after extubation while just the routine breathing exercises were used for control group. Arterial blood gases of all patients were measured before surgery, after extubation, second and the third postoperative days, and analyzed by independent t test.

Results: the arterial blood gases measured in before surgery, after extubation, first and second days were the same in intervention and control groups. In the third postoperative day, there was a significant difference in the mean of arterial blood oxygen (81.3±4.6 vs. 72.7±7.1 respectively, p=0.01), arterial blood carbon dioxide (37 ±1.9 vs. 43.7±3.2 respectively, p >0.001) and oxygen saturation (96.8±1/4 vs. 90.5±2.1 respectively, p >0.001).

Conclusion : in terms of the results, the deep breathing exercise is significantly more effective in improvement of blood arterial gases parameters.