The interactive effect of preoperative consultation and operating room admission by a counselor on anxiety level and vital signs in patients undergoing Coronary Artery Bypass Grafting surgery. A clinical trial study

Objective. The purpose of this study was to provide appropriate preoperative supportive conditions to improve anxiety and vital signs for patients undergoing Coronary Artery Bypass Grafting -CABG- surgery. Methods. This clinical trial study was performed on 90 patients undergoing CABG surgery in Farshchian Hospital of Hamadan, Iran in 2019. Sample was selected by convenience and were randomly divided into three groups: control (n=30), intervention1 (n=30), and intervention2 (n=30). The control group received only the routine preoperative counseling of ward and admitted to the operating room as usual; the intervention1 and intervention2 groups in addition received another two counseling sessions, then the intervention1 group was admitted in the operating room as usual, but the intervention2 group was admitted by the counselor in the operating room. Data were collected using a three-part questionnaire including demographic characteristics, vital signs chart, and the Spielberger's State-Trait Anxiety Inventory. Results. The results showed that there was a significant difference in the mean anxiety of the three groups after admission in the operating room (intervention2 was lower than intervention1 and control groups, p<0.001; and intervention 1 group was lower than control group, p<0.001) and also there was a significant difference between the mean systolic blood pressure, heart rate and respiratory rate of the three groups (p<0.001) but the mean of the variables of temperature and diastolic blood pressure in the three groups were not significantly different (p=0.59 and p=0.225, respectively). Conclusion. Our results revealed preoperative consultation and admission in the operating room by the consultant can reduce the level of anxiety and stability of vital signs of patients undergoing CABG

Objetivo. Evaluar si las condiciones de apoyo preoperatorias mejoran la ansiedad y los signos vitales para los pacientes sometidos a cirugía de bypass de arterias coronarias (CABG por sus siglas en inglés). Métodos. Este estudio clínico se realizó en 90 pacientes sometidos a cirugía de revascularización coronaria -CABG- en el Hospital Farshchian de Hamadan en Irán. La muestra se seleccionó por conveniencia y se dividió aleatoriamente en tres grupos: control (n=30), intervención1 (n=30) e intervención2 (n=30). El grupo de control recibió solamente la consejería preoperatoria de rutina cuando ingresó a hospitalización y en el momento de admisión en la sala de cirugía; los grupos de intervención1 e intervención2 además de la consejería rutina recibieron otra sesión adicional; y cuando se admitió el grupo de intervención2 en la sala de operaciones, lo acompañó la misma persona que hizo la consejería. Los datos se recopilaron mediante un cuestionario de tres partes que incluyó características demográficas, un cuadro de signos vitales y los puntajes del State-Trait Anxiety Inventory de Spielberger. Resultados. Los hallazgos mostraron que hubo diferencia significativa en el puntaje de ansiedad de los tres grupos después de la admisión en la sala cirugía (en intervención2 fue menor que en los grupos intervención1 y control, p<0.001; y en el grupo de intervención1 fue menor que en el grupo de control, p<0.001). También se encontraron diferencias estadísticamente significantes para las diferencias en la presión arterial sistólica, la frecuencia cardíaca y la frecuencia respiratoria de los tres grupos, pero no para las variables de temperatura y presión arterial diastólica (p=0.59 y p=0.225, respectivamente). Conclusión. Nuestros resultados revelaron que la consulta preoperatoria y la admisión en el quirófano por parte del consultor pueden reducir el nivel de ansiedad y la estabilidad de los signos vitales de los pacientes sometidos a CABG.

Objetivo. O propósito deste estudo foi avaliar se as condições de apoio pré-operatórias melhoram a ansiedade e os signos vitais para os pacientes submetidos a cirurgia de bypass de artérias coronárias (CABG por suas siglas em inglês). Métodos. Este estudo clínico se realizou em 90 pacientes submetidos a cirurgia de revascularização coronária -CABG- no Hospital Farshchian de Hamadan no Irão. A mostra se selecionou por de conveniência e se dividiu aleatoriamente em três grupos: controle (n=30), intervenção1 (n=30) e intervenção2 (n=30). O grupo de controle recebeu somente o aconselhamento pré-operatória de rotina quando ingressou a hospitalização e no momento de admissão na sala de cirurgia; os grupos de intervenção1 e intervenção2 ademais do aconselhamento de rotina receberam outra sessão adicional; e quando o grupo de intervenção2 foi admitido na sala de operações foi acompanhado pela mesma pessoa que fez o aconselhamento. Os dados se recopilaram mediante um questionário de três partes que incluiu características demográficas, um quadro de signos vitais e as pontuações do State-Trait Anxiety Inventory de Spielberger. Resultados. As descobertas mostraram que houve diferença significativa na pontuação de ansiedade dos três grupos depois da admissão na sala cirurgia (em intervenção2 foi menor do que nos grupos intervenção1 e controle, p<0.001; e no grupo de intervenção1 foi menor do que no grupo de controle, p<0.001). Também se encontrou diferenças estatisticamente significantes para as diferenças na pressão arterial sistólica, a frequência cardíaca e a frequência respiratória dos três grupos, mas não para as variáveis de temperatura e pressão arterial diastólica (p=0.59 e p=0.225, respectivamente). Conclusão. Nossos resultados revelaram que a consulta pré-operatória e a admissão na sala de cirurgia por parte do consultor podem reduzir o nível de ansiedade e a estabilidade dos signos vitais dos pacientes submetidos a CABG.

[ effectiveness, side effects and acceptability of locally available brand of Clopidogrel [Osvix] as antiplatelet tablet in CABG patients]

Background: Platelet activation and aggregation plays an essential role in the formation of coronary artery thrombosis. Nowadays, the Clopidogrel is administered orally as an inhibitor of platelet aggregation. Due to the high price of the original brand of Clopidogrel [Plavix], an Iranian brand of Clopidogrel [Osvix] has been produced

This study was conducted to evaluate the effectiveness, side effects and acceptability of locally available brand of Osvix as anti platelet tablet in coronary artery bypass grafting patients in comparison to the original brand (Plavix) by means of platelet aggregation indexes

Methods: This clinical study, was conducted at Heart Center of Ekbatan university Hospital in Hamadan in October 2011 to May 2012. In this study 80 patients undergoing coronary artery bypass grafting [CABG] were participated in two independent treatment groups. One group used the Iranian brand of Osvix and other one used the original brand [Plavix] as an inhibitor of platelet aggregation. To evaluate the effectiveness of these two in-inhibiting platelets regimens, blood samples were taken from the patients and platelet aggregation test was performed using Helena Biosiences Europe, PACKS4 aggrigometry system [made in France]

Results: Mean platelet-rich plasma amount for the Osvix and Plavix treatment group was 236.260 and 153.290 respectively

Results showed a statistically significant difference in the rate of platelet-rich plasma by two above mentioned treatment groups

There was no observed statistical difference in side effects of two studied treatment groups. It must be noted that the effectiveness of Plavix tablet regimen as a platelet aggregation inhibitor in patients undergoing CABG was higher than the Osvix tablet treatment regimen

Conclusion: This study showed the Iranian brand of Clopidogrel [Osvix] is significantly different from the original brand (Plavix) in terms of performance factors in preventing platelet aggregation in patients undergoing coronary artery bypass grafting

[ study of reliability and validity of the teacher evaluation form and factors affecting student's evaluation of teachers]

Background and Objective: Evaluation is an essential process for educational institutions, and one of the most common methods of evaluation of teachers is evaluation by students. Students are the real customers in the educational process; therefore, their judgments should be important variables in determining teaching status of teachers. According to customer-centric principles, the consumer's satisfaction must be met. This study assessed the validation of the current teacher evaluation form in theoretical courses

Methods: This was a cross-sectional study investigating the validity and reliability of the teacher evaluation form that is completed by students, and identifying some factors affecting student evaluations. To determine content validity of the teacher evaluation form, 20 expert teachers were selected proportional to the number of teachers of each school of the Hamadan University of Medical Sciences. To assess the reliability coefficient of the form, 189 students were selected from different schools by proportional random sampling

Results: According to the results, questions such as rate of adherence to the determined topics, providing practical application of teaching materials, and the efficacy of determined assignments did not have the necessary validity score. However, the results indicated that validity of the questionnaire was acceptable. In the present study, the Spearmen-Brown correlation coefficient indicated that the teacher evaluation form did not have an acceptable reliability [r = 0.456, P < 0.001]

Conclusion: The current teacher evaluation form has an acceptable content validity, but it does not seem reliable

Relationship between managerial skills and employees job stress in health centers

Job stress is one of the important issues in the health sector and its high effect on workers' productivity. Managerial skills can help organizations to improve employees' effectiveness and reduce job stress. The present study investigated the relationship between employees' job stress and managers' professional skills. This cross-sectional and correlation study was conducted in 2010.We selected 90 health workers of 13 Health and Treatment Centers in Razan Health Center, western Iran. All data were gathered using self-administered questionnaires. Employees' job stress levels were measured using the Eliot Stress Questionnaire and managers' professional skills were assessed using the standard Questionnaire with 40- items in Likert format. Data were analyzed u SPSS software and Pearson correlation coefficient and Kendall correlation tests. 87.7% of employees had mid- level of job stress. The professional skills level was high in 36.7% of health managers; moderate in 56.6%, and low in 6.7%. In addition the human skill was highest level among all managers' professional skills. A significant and negative correlation was found between job stress and managers' human, conceptual and design skills [P <0.005]. The level of managers' professional skills was significantly related with employees' job stress, thus training and developing managerial skills especially human, conceptual and design skills in supervisors and managers of health centers can reduce job stress and enhance effective performance.