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Abstract

Aim. The aim of this study was to examine the effect of foot reflexology massage on incisional pain in thoraco-abdominal surgery patients admitted to surgery intensive care unit.

Background. Although the most commonly used method of pain relief is pharmacologic, the medications prescribed excessively for severe and chronic pain in patients have side effects and non-pharmacological methods of pain relief may be useful.

Method. In this quasi-experimental study, 102 patients within the age range of 25 to 50 years without any other surgical complication, and normal feet which have undergone thoraco-abdomical surgery were enrolled. They were randomly allocated into 3 equal groups: massage group, pseudo-massage group and control group. The pain was measured Visual Analogue Scale (VAS) before, right after, 10 minute and 24 hours after the treatment. Other data was extracted from medical records. The information was analyzed by SPSS using appropriate statistical tests.

Findings. According to the findings, there were no statistically significant difference between the groups in terms of age sex marital status educational levels underlying diseases and type, duration and severity of the surgery. The pain score was not significantly different between groups before and right after the intervention. However, 10 minutes and 24 hours after the intervention, pain score was lower in the massage group. The use of pharmacological analgesics had also reduced in the massage group.

Conclusion. Foot reflexology was effective on incisional pain after thoraco-abdominal surgery. Nurses can use this intervention to improve patient comfort and decrease  pain medications administration in thease patients.

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Aim. The aim of this study was to investigate the effect of applying checklist on intra-hospital transport of intensive care patients. Background. Intra-hospital transport of intensive care patients who are at risk of cardiovascular and respiratory instability can lead to physical harm and death. Therefore, prevention through increasing awareness staff about the dangers is a necessity. Method. A quasi-experimental before-after design was used to conduct the study. At first, in a hospital affiliated to Tehran University of Medical Sciences, the quality of 50 cases of intra-hospital transport observed using a checklist during day shifts. Then, intra-hospital transport checklist was given to critical care nurses to be used in cases of patient transport. One month later, the quality of 50 cases of intra-hospital transport observed using a checklist during day shifts. The data were analyzed by SPSS version 21. Findings. The results showed a statistically significant difference between the mean score of the quality of intra-hospital transport, before and after intervention (49.26±9.87 against 54.95±10.27) (P=0.006). Conclusion. Applying checklist improves intra-hospital transport of intensive care patients. It is recommended to use this checklist for intra-hospital transport of intensive care patients to increase patient safety and reduce the complications of in-hospital transport .

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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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Abstract

Aim. This study was conducted to examine the effect of combined inhalation of lavender oil, chamomile and Neroli oil on vital signs of patients with acute coronary syndrome.

Background. Increase in vital signs in patients with acute coronary syndrome worsens the disease and increases anxiety. The use of complementary medicine for better patient outcomes has been usually considered by the nurses due to the low complications and relatively low costs.

Method. This was a single-blinded, randomized clinical trial that carried out at the Emam Sajad Hospital in Shahryar, Tehran, Iran in 2016.  After obtaining the approval from the Ethics Committee of Iran University of Medical Sciences, 75 patients aged 20 to 80 years who signed the informed consent were recruited and randomly allocated into three groups (control, placebo, and intervention groups) using block randomization design (25 subjects in each group). In the intervention group, patients were asked to strew 2 drops of the aroma on an eye pad, keep their hands at the distance of 5 cm from their nose and take deep breath 10 times. After this, the pad was placed beside the pillow of the patient until the next morning. In the placebo group, this process was carried out using distilled water and the control group received routine care. The patients’ vital signs were measured before intervention, one hour after and every four hours after intervention until the next morning. Data were analyzed in SPSS, version 22, using chi-square test, t-test and ANOVA.

Findings. Before intervention, there was no statistically significant difference between three groups in terms of demographic characteristics as well as pulse rate, respiratory rate, systolic and diastolic blood pressure. The results showed that the combination of three aromas decreased pulse rate, respiration rate, systolic and diastolic blood pressure in one, four, eight and twelve hours after the intervention in the aromatherapy group compared to the time before the intervention.

Conclusion. The use of aroma as a complementary method in patients with acute coronary syndrome could decrease their pulse rate, respiratory rate, systolic and diastolic blood pressure. Due to the low risk and suitable accessibility to these aromas, the results can be used by nurses in the critical care unit and patient caregivers to improve patients' vital signs.