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Abstract

Aim. The purpose of this study was to determine the effect of comprehensive-care program on patient satisfaction in patients with minor and moderate trauma (accident, fall and other types of trauma) in emergency department.

Background. Assessment of patient satisfaction is one of the most important indicators of measuring quality of care. Patient satisfaction of nursing services is declining it can be caused by increased awareness of patients about their rights and health care services which leads to an increase in patient expectations of health care services. Comprehensive care program is one of the ways to increase patient satisfaction.

Method. This clinical trial study was conducted with 104 patients, 52 in each control and experimental groups. The experimental group received comprehensive-care program from the moment of entering emergency department to the discharge of emergency department and the control group received the usual nursing care. After implementing comprehensive-care program and at the end of the patient stay, the patient satisfaction in two groups was measured using a modified form of satisfaction questionnaire. The data analysis was done by SPSS software, version 22 using descriptive and inferential statistics.

Findings. The mean score of the total satisfaction was 32.02 (relatively appropriate) and 45.6 (appropriate) after intervention in control and experimental groups, respectively. There was a statistical significant difference between the mean score of total satisfaction of the groups after intervention (p<0.001).

Conclusion. Implementing comprehensive-care program increases the rate of the patient satisfaction. Therefore, it is recommended to managers and staff of the health care centers and educational centers to apply comprehensive care program.

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Aim. The purpose of this study was to examine the effect of acupressure on anxiety in patients under mechanical ventilation. Background. Mechanical ventilation is a frequently used technological modality for patients in Intensive Care Unit (ICU), and this treatment has potential to produce a variety of unpleasant stress and physiological and psychological complications. Anxiety is one of the most common mental reactions in patients under mechanical ventilation. Acupressure as a non-pharmacological approach may improve anxiety in these patients without side effects. Method. This was a randomized block experimental study in which 164 ventilated patients with stable hemodynamics and GCS≥9 who had study criteria were randomly allocated into experimental or control group. Patients in the experimental group received two sessions/day of acupressure along with routine care for two consecutive days, but patients in the control group received only routine care. The anxiety was measured with Faces Anxiety Scale (FAS), before, right after, and one hour following every acupressure session. The data were analyzed by SPSS software using descriptive and inferential statistics. Findings. Baseline anxiety level was high in most of patients. Anxiety in the experimental group decreased significantly (p=0.032) when compared with control group, over time. Anxiety was significantly different between groups, right after intervention in every session of acupressure (p<0.0001). In the experimental group, time-dependent changes of anxiety was statistically significant (p<0.0001) and anxiety was significantly different before and right after intervention in every session of acupressure (p<0.0001). The amount of change in anxiety was not significantly different between sessions. Conclusion. Acupressure therapy could reduce anxiety significantly in patients with mechanical ventilation. Critical care nurses can use this non-pharmacological approach to reduce anxiety in patients under mechanical ventilation.

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Aim. This study aimed at investigating the effect of education based on illness perception on self-care behaviors of patients with heart failure.

Background. Heart failure is the final outcome of most cardiovascular diseases, reducing patients’ self-care behaviors as a chronic condition. Changing illness perception of patients with heart failure about the disease is a way to improve the self-care behaviors in these patients.

Method. An experimental design was used to conduct the study. Seventy and six patients with heart failure who admitted to hospitals affiliated to Tehran University of Medical Sciences and were eligible to participate in the study was recruited in 2014 and were randomly divided into intervention and control group. The intervention group attended in three educational sessions and received cell phone follow-up for 8 weeks. The control group received conventional treatment. The self-care behaviors was compared in both groups before, and eight weeks after the intervention. The data were analyzed by SPSS-16 software.

Findings. There was no statistical significant difference between demographic variables of two groups. Self-care behaviors in the intervention group increased after the intervention when compared with the control group (p<0.0001). In the experimental group, the mean score of self-care behaviors after the intervention was significantly higher than mean score before intervention (p<0.0001).

Conclusion. The results showed that education based on illness perception affects self-care behaviors in patients with heart failure. It is suggested as an effective method to promote the self-care behaviors in these patients.