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Aim. This study was conducted to examine the effect of acupressure on severity of pain and fatigue in patients with chronic heart failure. Background. Patients with chronic heart failure experience high levels of pain and fatigue. Acupressure is a simple, inexpensive and non-invasive method which may reduce the pain and fatigue in patients with chronic heart failure. Method. In this single blind randomized clinical trial, 72 patients with chronic heart failure were recruited. Subjects were equally divided into two groups of experimental and placebo, by random allocation method. Then visual analogue scale and fatigue severity scale was used to evaluate the severity of pain and fatigue in each group. The members of experimental group were under acupressure in KI3 , GV20 and CV6 point for 3 minutes bilaterally. In addition, the participants were instructed to perform acupressure in same point three times a day for four weeks. Subjects in placebo group were trained to touch the points. Four weeks after intervention, the severity of pain and fatigue was measured in both groups. The data were analyzed by SPSS. Findings. The study findings showed no statistically significant difference between the groups in terms of demographics, and severity of pain (p=1.000) and severity of fatigue (p=0.285) before intervention. After four weeks of intervention, a statistically significant relief on severity of pain (p=0.006) and fatigue (p≤ 0.0001) was seen in experimental group compared with placebo group . Conclusion. Acupressure can be effective in decreasing severity of pain and fatigue in people with chronic heart failure.

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Abstract

 Aim. The aim of this paper is to review studies related to fatigue in patients with heart failure.

 Background. Fatigue is a subjective feeling and a multifactorial phenomenon in patients with heart failure. Fatigue is an important symptom of heart failure; however, lack of information exist regarding this phenomenon. Also, fatigue is considered as a challenge by health care providers and clinical guidelines have paid less attention to fatigue in these patients. 

 Method. This article reviewed studies published regarding fatigue in patients with heart failure. The studies were searched out through scientific databases, including PubMed and Science Direct by the keywords fatigue, predictors, related factors, heart failure and their Persian equivalents.

 Findings. The literature review revealed that the prevalence of fatigue in patients with heart failure is high and different findings have been reported regarding its severity in these patients. Fatigue and its increasing trend during the disease progress is related to unsatisfactory quality of life and clinical outcome. In various studies, multiple factors including the nature of the illness and psychological factors particularly depression have been reported as predictors of fatigue and its severity in patients with heart failure. Few studies were conducted with the aim of evaluating the effect of non-pharmacological intervention on management of fatigue in these patients.

 Conclusion. According to the high prevalence of fatigue in patients with heart failure, it is essential to consider timely interventions by health care providers, particularly nurses, for reducing it and improving patients’ well-being. Regarding the limitation of studies and importance of reducing fatigue, it is necessary to conduct further research to evaluate the effect of non-pharmacological interventions on symptom management (especially fatigue) in these patients.

 

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Abstract
Aim. The purpose of this study was to determine the relationship between compassion fatigue and moral sensitivity in nurses of critical care units of hospitals affiliated to Qazvin University of Medical Sciences. 
Background. Nurses encounter conditions during taking care for clients that can lead to a type of fatigue called compassion fatigue. Ethical sensitivity as the basis of ethics in nursing can be helpful in reducing nursing care problems.
Method. This study was a cross-sectional descriptive-correlational study in which 200 nurses working in critical care units of hospitals affiliated to Qazvin University of Medical Sciences were recruited in the study through census sampling method and inclusion criteria. Demographic characteristic form, and the compassion fatigue questionnaire and moral sensitivity questionnaire was used for data collection. Data were analyzed in SPSS version 19 using descriptive and inferential statistics.
Findings. The mean score of moral sensitivity was 53.21±13.69 and the mean score of compassion fatigue was 25.55±4.66. Spearman correlation coefficients revealed that there was a statistically significant and reverse correlation between moral sensitivity and compassion fatigue among critical care nurses (r=0.171, p=0.015).
Conclusion. The moral sensitivity of critical care nurses is related to their compassion fatigue. Therefore, provision of a framework for strengthening the moral sensitivity of nurses could be effective in reducing this phenomenon.

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Method. This research was semi-experimental with a pre-test post-test design and control group within a three-month follow-up period. Forty five men with heart failure were purposefully selected and randomly allocated to two experimental groups and one control group (15 people in each group). Data were collected in three stages using the Iowa Fatigue Scale, and Minnesota Living with Heart Failure Questionnaire. Data analysis was done in SPSS-25 software with mixed analysis of variance test.

Findings. After intervention and in follow-up stages, both mindfulness-based cognitive therapy and acceptance and commitment therapy were effective on fatigue and quality of life in men with heart failure. The follow-up test showed a greater effect of acceptance and commitment therapy on quality of life and no statistically significant difference was found between the experimental groups in terms of effect on fatigue. 

Conclusion. Both interventions, especially acceptance and commitment therapy, can be used as effective interventions on fatigue and quality of life along with medical treatments for men with heart failure in medical centers.