Evaluating the Relationship between Nursing Care Quality and Hospital Anxiety and Depression among Old Patients with Cardiovascular Disease.

Introduction: Cardiovascular disease (CVD) is a prevalent condition among older adults' hospitalizations leading to psychological complications. Nursing care is the longest intervention the patient receives. This study evaluated the relationship between nursing care quality and anxiety and depression among old patients with CVD. Methods: This is a descriptive cross-sectional correlational study that included 250 old patients with CVD admitted to an 'age-friendly hospital'. Using the convenience sampling method. The data collection tools included the Hospital Anxiety and Depression Scale (HADS) and the Quality Patient Care Scale (QUALPACS). Data were collected through conducting interviews and analyzed in SPSS ver.13 via statistical tests such as correlation coefficients, independent t-test, and ANOVA. Results: Overall, 229 (91.6%) of patients received the desired nursing care quality. The mean (SD) scores for anxiety were 1.52 (1.14) and depression 2.18 (1.51), indicating a less than average hospital anxiety and depression. There was an inverse correlation between anxiety and nursing care quality. Conclusion: A combination of high-quality nursing care and clinical governance criteria in an age-friendly hospital can reduce anxiety in old patients.

The social network among the elderly and its relationship with quality of life.

INTRODUCTION: Attention to the needs of the elderly is a social necessity, and it seems that evaluating the social network and quality of life of the elderly can be useful in a better understanding of their needs. This study was performed to determine the relationship between the social network and the quality of life of the elderly in the city of Bojnoord in Iran. METHODS: In this cross-sectional study, 201 elderly people aged 60 years or more were selected by continuous and consecutive sampling method in Bojnoord, Iran in 2014. Data were collected using demographic questionnaire, Lubben social network scale and LEIPAD elderly quality of life questionnaire. Data were analyzed by SPSS 16 and using descriptive statistics and independent-samples t-test, ANOVA and Pearson product-moment coefficient. RESULTS: The results showed that 30.3% of elderly people studied, were subjected to a high risk of isolation. The highest mean in social network dimensions was in the family (19.68%), friends (12.01%) and the neighbors (9.90%), respectively. The mean score for quality of life of the elderly was as moderate to high (63.90±13.73), and among the quality of life dimensions, the highest mean was related to the self-care dimension (15.59%), and the lowest mean was related to the sexual functioning dimension (1.53%). The findings suggested a positive and significant relationship between social network and quality of life in the elderly who were studied (p<0.000, r=0.468). CONCLUSION: This study was a step toward understanding the social network status and quality of life of the elderly. It is necessary to say that health care professionals, especially nurses, display a significant role in the community to help people in this regard.

The Effects of Kangaroo Care on the Sleep and Wake States of Preterm Infants.

BACKGROUND: Developing interventions that improve deep sleep and quit awake is important to improve the quality of care that is provided to preterm infants. PURPOSE: The aim of this study was to compare the effects of kangaroo care and in-arms-holding on the sleep and wake states of preterm infants. METHODS: A randomized controlled trial design was employed in 2011-2012. Seventy-two stable preterm infants with gestational ages of 32-37 weeks and their mothers were recruited from the neonatal intensive care unit of Valiasr Hospital in Tehran, Iran. Seventy participants completed the trial. In the preintervention phase, nurses placed all of the infants, clad only in diapers, in supine position in their incubator for 20 minutes. Next, the infants in the kangaroo care group were placed onto their mothers' bare chest, whereas those infants in the in-arms-holding group were cradled in their mothers' arms, with the head and back supported by the mother's left arm. The intervention period lasted for 70 minutes. In the postintervention phase, the infants were returned to their incubators and placed in supine position for 20 minutes. The observer recorded the status of the infants during the three phases of study. RESULTS: There were no significant differences between the two groups in terms of state distribution in the preintervention phase. However, the kangaroo care group had longer periods in deep sleep (p < .001) and in the quiet awake/alert state (p = .004) during the intervention phase and less time in the light sleep or drowsy state (p < .001) and in the actively awake state (p = .02) than the in-arms-holding group. No significant group differences were found in terms of crying. CONCLUSIONS: Kangaroo care appears to increase the length of time that preterm infants spend in deep sleep and quiet awake states as compared with simply being held in their mothers' arms. Replication of this research will strengthen the results.

Perceptions of people living with Parkinson's disease: a qualitative study in Iran.

AIM: This study explores the primary concerns and perceptions of patients living with Parkinson's disease (PD). METHOD: This was an exploratory qualitative study. A purposive sample of 17 patients with PD who were attending a hospital outpatients' neurology clinic in Iran were recruited. Study data were collected through semi-structured interviews and analysed using the conventional qualitative content analysis approach. FINDINGS: We identified the 'fear of becoming disabled' as a primary concern in these patients. This concern affected the physical, emotional, mental, and social aspects of their lives. The 'fear of becoming disabled' fell into four categories, including progressive physical disability, mental alteration, decreasing social connectedness, and self-change. CONCLUSION: The study results showed that older adults with PD face a number of challenges in self-care. In addition, the 'fear of becoming disabled' was the main concern of patients with PD, particularly in late stages of the disease.

Effect of Acupressure on Maternal Anxiety in Women With Gestational Diabetes Mellitus: A Randomized Clinical Trial.

Women with diabetes often experience a higher level of anxiety. The aim of the study was to evaluate the effect of acupressure on relieving anxiety of women with gestational diabetes mellitus (GDM). A randomized clinical trial was conducted on 60 women with GDM at a university hospital. The participants were allocated to an experimental and a placebo group (30 women per group). The experimental group received a nurse-provided acupressure at the true point, and the placebo group received pressure (touching) at a sham (false) point. Anxiety was measured immediately in the groups prior to and after a 2-day intervention by a questionnaire and the Visual Analogue Scale. The data were analyzed using descriptive and inferential statistics. Results indicated that the acupressure group had significantly lower anxiety than the placebo group (p ≤ .0001). In conclusion, the effects of acupressure appeared to be effective in reducing anxiety in diabetic pregnant women.

The effect of acupressure on cancer-related fatigue among school-aged children with acute lymphoblastic leukemia.

BACKGROUND: Fatigue is the most common side effect of chemotherapy in children with acute lymphoblastic leukemia (ALL). Acupressure is one of the most popular non-pharmacologic methods used to reduce fatigue in other settings. The aim of the study was to evaluate the effect of acupressure on reducing fatigue among children with ALL compared with a placebo treatment. MATERIALS AND METHODS: In a single-blind, randomized, placebo-controlled clinical trial of 120 hospitalized school-aged children with ALL, 24 h after chemotherapy, they were randomly divided into experimental (n = 60) and placebo groups (n = 60). Intensity of fatigue was rated using the Visual Analog Scale. The intervention (finger acupressure) was applied on ST36 (true points) in the experimental group and on LI12 (sham points) in the placebo group. We evaluated the symptoms of fatigue intensity immediately and 1 h after intervention. Fatigue was also measured 24 h after intervention by Fatigue Scale-Child (FS-C). Data were analyzed by SPSS version 16.0 using descriptive statistics, independent t-test, and Chi-square and Fisher exact tests. RESULTS: Significant differences were observed between the two groups in the intensity of fatigue 1 h after intervention (P < 0.001). But there was no significant difference between them regarding fatigue 24 h after intervention. CONCLUSIONS: Applying one time acupressure may reduce the intensity of fatigue at 1 h post-treatment. Therefore, acupressure could be recommended as an effective, non-pharmacologic method for some CRF control. Applying one time acupressure did not have a long-term effect.

Effect of acupressure on fatigue in women with multiple sclerosis.

INTRODUCTION: Multiple sclerosis (MS) is the most common cause of progressive neurological disability. The prevalence of MS is much more common in women than men. The women are exposed to a variety of symptoms including fatigue. Acupressure is a noninvasive procedure that can be used to control symptoms including fatigue. The aim of the study was to evaluate the effect of acupressure on fatigue in women with multiple sclerosis. METHODS: A randomized clinical trial was conducted on 100 women with MS at Tehran MS Association. The subjects were equally allocated to experimental group and a placebo group (50 women per group) by blocking randomization method. The experimental group were received acupressure, at the true points (ST36, SP6, LI4) and the placebo group, were received touching at the same points. Fatigue was measured by a Fatigue Severity Scale (FSS) in the groups at immediately prior to, two and four weeks after the beginning of the intervention. The data was analyzed using descriptive and inferential statistics by SPSS version 17. RESULTS: The findings indicated no differences in demographic characteristics and the severity of fatigue at the baseline in two groups (p=0.54). But there were significant reductions of the mean score of fatigue in the experimental group compared to the placebo group immediately, two and four weeks after the intervention respectively (p=0.03, p?0/001, p=0.04). CONCLUSION: According to the findings, the study provided an alternative method for health care providers including nurses to train acupressure to the clients with MS to managing their fatigue.

Effect of Family-centered Care on Improving Parental Satisfaction and Reducing Readmission among Premature Infants: A Randomized Controlled Trial.

INTRODUCTION: Healthcare quality is usually evaluated through analysing medical outcomes including neonatal readmission and patient and family satisfaction. Parental involvement in neonatal care is considered as one of the most important factors, which directly affects these outcomes. The aim of the present study was to determine the effect of family-centered care including maternal participation, presence, and information about neonatal care, on maternal satisfaction and neonatal readmission; the care services were provided by the primiparous mothers of preterm infants. MATERIALS AND METHODS: One hundred and ten primiparous mothers with preterm infants participated in this clinical trial. All samples were randomly divided into family-centered care (FCC) and control groups, through simple random sampling. The FCC program, which consisted of information about neonatal care, maternal presence, and participation in the care process, was implemented in the FCC group, while the control group was provided with routine care. Data were obtained using demographic and satisfaction questionnaires and readmission checklist. RESULTS: In the FCC group, the mean score of satisfaction increased after the implementation of the program (22.36 and 59.28 before and after the program, respectively) (p<0.001); however, this increase in the control group was not significant. The obtained results regarding the different aspects of satisfaction indicated that mothers in the FCC group were more satisfied with maternal presence in the neonatal intensive care unit (NICU), compared with aspects of information and participation. In addition, the number of neonatal readmission was less in the FCC group compared with the control group, and the mean duration of hospitalization was 6.96 and 12.96 days in the FCC and control groups, respectively (p<0.001). CONCLUSION: FCC program seems to be effective in increasing maternal satisfaction and decreasing neonatal readmission. Therefore, it seems necessary that healthcare authorities of the departments of obstetrics and gynecology in Iran provide the opportunity for the implementation of such programs in clinical environments, which follow the policy of parental absence and participation in the intensive care units.

Quality of life in women with coronary artery disease.

BACKGROUND: Coronary artery disease (CAD) as a chronic disease can affect physical, mental, and social aspects of health as well as the perception of wellbeing. Advanced treatments of the disease emphasize on functionality and quality of life (QOL). OBJECTIVES: The present study aimed to investigate the QOL and its related factors among women with CAD. PATIENTS AND METHODS: This was a descriptive cross-sectional study conducted on 200 women with CAD, referring to the Heart Clinic of Shahid Rajaei Cardiovascular Center in Tehran, Iran. The participants were selected by convenient sampling method. Data were collected using the Persian version of Ferrans and Powers QOL index (QLI) cardiac version and then analyzed using descriptive statistics and statistical tests (independent t-test, one-way ANOVA, and Scheffe's test). RESULTS: The mean score of overall QOL was 16.91 ± 3.54, ranging between 7.17-27.63. Regarding the instrument subscales, the mean scores were as follows: health and functioning: 15.48 ± 4.32, social and economic: 16.18 ± 3.65, psychological/spiritual: 18.04 ± 4.36, and familial: 20.12 ± 4.57. There was a significant relationship between QOL and marital status (P = 0.004), education (P = 0.007), income (P < 0.001) and disease duration (P = 0.047). However, there was no significant association between QOL and age, job and comorbidity. CONCLUSIONS: Based on the findings, participants had average levels of overall QOL. Some domains showed the need to improve QOL of women with CAD. Results of the present study revealed the necessity of designing and performing educational and supportive interventions to improve the QOL in women with CAD, especially among patients with low socio-economic status.

Cross-cultural adaptation of a patient-based tool for evaluating the implementation of patient education in acute care settings.

OBJECTIVE: The purpose was cross-cultural adaptation, validation, and psychometric analysis of an originally Norwegian patient-based tool measuring the patient education practices of the nurses. METHODS: Systematic translation and validation of the Patient Information and Nurse Interaction (PINI) scale was performed. Exploratory factor analysis of the modified Persian version was conducted using a sample consisting of 163 Persian-speaking patients discharging from a neurosurgery unit. RESULTS: The scale included three factors, cumulatively accounting for 61% of the variance. The first factor with seven items reflected "providing information on treatment and care plans". The second and the third factors each contained four items and reflected "nurses' interactions with the clients" and "providing advice on care after discharge", respectively. Alpha coefficients were 0.90 for the overall scale, 0.87 for the first, 0.77 for the second, and 0.88 for the third subscale. CONCLUSION: The study supported that the modified scale had good psychometric properties measuring three major components including providing information, interaction with the client, and providing advice about post-discharge care. PRACTICE IMPLICATIONS: It seems that the modified version of the PINI scale can provide sound assessment of the implementation of patient education in a different acute care setting with a new language and culture.

Disrupted social connectedness in people with Parkinson's disease.

A study was conducted to explore the effects of Parkinson's disease on people's social interactions. An exploratory qualitative design was used. Participants were a purposive sample of 10 people with Parkinson's disease who were attending a hospital outpatients' neurology clinic. Data were collected by semi-structured in-depth interviews. All interviews were transcribed and analysed by using conventional content analysis to explore the participants' experiences and perceptions on social interactions, using the central question 'what effect does Parkinson's disease have on people's social interactions?' Analysis revealed that Parkinson's disease affected social interactions by disrupting social connectedness. Social connectedness was disrupted by a number of factors, including 'progressive physical disability, mood disturbances, shrinking of social activities and secluding oneself. Older adults with Parkinson's disease therefore face a number of challenges to remaining socially connected. It appears that disrupted social connectedness is one of the negative consequences of living with Parkinson's.

Does relaxation education in anxious primigravid Iranian women influence adverse pregnancy outcomes?: a randomized controlled trial.

UNLABELLED: Maternal anxiety and stress are found to be predictors of adverse pregnancy outcomes, including low birth weight and prematurity. OBJECTIVE: The aim of the study was to determine whether relaxation education in anxious pregnant Iranian women in their first pregnancy affects selected pregnancy outcomes, including birth weight, preterm birth, and surgical delivery rate. SUBJECTS: A total of 110 obstetrically and medically low-risk primigravid women in Iran with a high anxiety level demonstrated by Spielberger's State-Trait Anxiety Inventory were randomly assigned into experimental and control groups. METHOD: In this randomized controlled trial, the experimental group received routine prenatal care along with 7-week applied relaxation training sessions, while the control group received only routine prenatal care. Anxiety and perceived stress were measured by pre-educational and post-educational intervention. Data related to pregnancy outcomes include birth weight, gestational age at birth, and type of delivery. RESULTS: Significant reductions in low birth weight, cesarean section, and/or instrumental extraction were found in the experimental group compared with the control group. No significant differences were found in the rate of preterm birth. CONCLUSION: The findings suggest beneficial effects of nurse-led relaxation education sessions during the prenatal period. This intervention could serve as a resource for improving pregnancy outcomes in women with high anxiety.

A randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women.

The purpose of this study was to investigate the effect of applied relaxation training on reducing anxiety and perceived stress among pregnant women. A randomized controlled trial with a prospective pretest-posttest experimental design was used. One hundred ten primigravid women (mean age = 23.8 years) in their second trimester (mean of gestational age = 17.8 weeks) were randomly assigned into experimental and control groups. The experimental group received routine prenatal care with applied relaxation training, and the control group received only routine prenatal care. State/trait anxiety was measured with the Spielberger State-Trait Anxiety Inventory, and perceived stress was measured with the Cohen Perceived Stress Scale. There were significant reductions in state/trait anxiety and perceived stress for the experimental group compared with the control group after the intervention. The findings suggest beneficial effects of relaxation on reducing anxiety and perceived stress in pregnant women. Teaching relaxation techniques could serve as a resource for improving maternal psychological health.