Comparison of intermittent and bolus enteral feeding methods on enteral feeding intolerance of patients with sepsis: a triple-blind controlled trial in intensive care units

Background: Recent trials have shown controversial results on which enteral feeding methods has a lower risk of enteral feeding intolerance. Therefore, we aimed to compare two methods of bolus and intermittent feeding on enteral feeding intolerance of patients with sepsis

Methods: This triple-blind randomized controlled trial was conducted on 60 patients with sepsis, who were fed through tubes for at least 3 days. The patients were randomly assigned into bolus feeding, intermittent feeding, and control groups. Enteral feeding intolerance of all patients was recorded in 3 consecutive days by a researcher-made checklist including the data on gastric residual volume, vomiting, diarrhea, constipation, and abdominal distension

Results: There were no significant differences between the three studied groups in none of the intervention days pertaining to constipation, diarrhea, vomiting, abdominal distention, and gastric residual volume [p > 0.05]. Also, no statistically significant difference was found between all variables in the three studied groups during the 3 days [p > 0.05]

Conclusion: As enteral feeding intolerance of patients with sepsis was similar in both bolus and intermittent feeding methods, it can be concluded that bolus method can still be used as a standard method to decrease the risk of enteral feeding intolerance if it is used properly

Effect of Roy's adaptation model-guided education on coping strategies of the veterans with lower extremities amputation: a double-blind randomized controlled clinical trial

Background: Any defect in the extremities of the body can affect different life aspects. The purpose of this study was to investigate the effect of Roy's adaptation model-guided education on coping strategies of the veterans with lower extremities amputation

Methods: In a double-blind randomized controlled clinical trial, 60 veterans with lower extremities amputation referring to Kowsar Orthotics and Prosthetics Center of Veterans Clinic in Tehran, Iran were recruited using convenience method and randomly assigned to intervention and control groups in 2013-2014. Lazarus and Folkman coping strategies questionnaire was used to collect the data. After completing the questionnaires in both groups, maladaptive behaviours were determined in the intervention group and an education program based on Roy's adaptation model was implemented. After 2 months, both groups completed the questionnaires again. Data were analyzed using SPSS software

Results: Independent T-test showed that the score of the dimensions of coping strategies did not have a statistically significant difference between the intervention and control groups in the pre-intervention stage [P>0.05]. This test showed a statistically significant difference between the two groups in the post-intervention stage in terms of the scores of different dimensions of coping strategies [P>0.05], except in dimensions of social support seeking and positive appraisal [P>0.05]

Conclusion: The findings of this research indicated that the Roy's adaptation model-guided education improved the majority of coping strategies in veterans with lower extremities amputation. It is recommended that further interventions based on Roy's adaptation model should be performed to improve the coping of the veterans with lower extremities amputation

[Development of adaptation questionnaire using roy's adaptation model and its psychometrics on veterans with lower limb amputation]

The Roy's adaptation model is a helpful instrument to be used in treatment processes of patients with chronic diseases. According to chronic nature of amputee veterans' diseases, it is expected that the implementation of care plans based on this model can increase adaptation in the patients. The present study was performed to design and determine validity and reliability of a researcher-designed adaptation questionnaire based on the Roy's adaptation model on war veterans with lower limb amputation. This study was conducted among war veterans referred to the veteran clinic of Orthotics and Prosthetics center using convenience sampling method during 2012-2014. Main concepts of adaptation defined based on the Roy's adaptation model were used to provide items. The validity and reliability of the questionnaire was assessed using the content validity index [CVI], content validity ratio [CVR], face validity, internal consistency [Cronbach's alpha], and stability [test-retest reliability] tests. Thirty five items were developed including 15 items on physiological area, 11 items on self-concept area, four items on dependence/ independence area, and five items on role playing area. The CVI was 0.95. The Cronbach's alpha was 0.78. The correlation coefficient values were more than 0.7 in each area. The psychometric analysis of the questionnaire showed proper validity and reliability for measuring adaptation on war veterans with lower limb amputation. The questionnaire is recommended to be used in nursing practice

General health status and burnout of the hematopoietic stem cell transplantation nurses in Tehran

Nowadays, it has been found that the mental state of caregivers may have a noticeable effect on both patient and caregivers health. This study was conducted to determine the burnout and general health status of the hematopoietic stem cell transplantation nurses in Tehran, Iran. In a cross-sectional study, burnout and general health status of 65 hematopoietic stem cell transplantation nurses in Tehran were examined. Each subject filled out two questionnaires in 2010: The General Health Questionnaire and the Maslach Burnout Inventory as well as demographic information. The data were gathered after obtaining the participants' agreement to take part in the study. The majority [67.7%] of the nurses had scores lower than the cut off score of the General Health Questionnaire-28. The majority of the nurses were in the low level in terms of emotional exhaustion [50.8%], depersonalization [66.2%], and personal accomplishment [58.5%]. The general health status score of the nurses was positively related to emotional exhaustion and depersonalization scores. However, there was an inverse relationship between health status and personal accomplishment scores. The result of the current study did not have a significant agreement with the general view indicating that working in hematopoietic stem cell transplantation units leads to an increase in burnout levels. Hence, the majority of nurses were in low levels in terms of emotional exhaustion and depersonalization and in good condition in terms of general health status; there is a need for conducting further studies in order to find out the reason behind these differences