Effects of religious and spiritual care on burn patients' pain intensity and satisfaction with pain control during dressing changes.

OBJECTIVE: Spiritual care, beside other nursing interventions, creates a balance in body, psyche and soul in order to holistically recover one's health. This research aims to study the effects of a religious and spiritual care program on the intensity of pain and the satisfaction with pain control during the dressing changes for the burn patients in a hospital in Iran in 2017. METHODS: This research is a clinical trial study conducting 68 burn patients. The samples were randomly divided into 'experimental' and 'control' groups. The experiment consists of three sessions of spiritual care carried out by the help of the nurse, a clergy and the patient's companion. These sessions have been done before, during and after the dressing change. The pain intensity and the satisfaction with pain control are measured by VAS1 and NRS2 devices. The data is analyzed via SPSS version 20 and through the statistical exams of independent t-test, paired t-test, chi-squared test and Mann-Whitney exam. RESULTS: Before the intervention, there was no significant difference in the average rate of pain (P = 0.25) and the satisfaction with pain control (P = 0.59) between the experimental and the control groups. While, after the spiritual care program was conducted, there appeared a significant difference (P < 0.001): there was a substantial reduction of pain intensity in the experimental group and the satisfaction with pain control in this group increased as well. CONCLUSIONS: A religious and spiritual care can help decrease the pain intensity caused by the dressing change and can increase the satisfaction of these patients with pain control. Therefore, it is recommended that the nurses apply the spiritual cares to alleviate the pain and to increase the satisfaction with pain control in burn patients.

The effect of sensory stimulation provided by family on arterial blood oxygen saturation in critical care patients.

BACKGROUND: Stressors in the intensive care unit (ICU) impair patients' comfort, excite the stress response, and increase oxygen consumption in their body. Non-medical interventions are recommended by several studies as a treatment to improve comfort in the ICU patients. Sensory stimulation is one of the most important interventions. Since arterial blood oxygen saturation is an important index of patients' clinical and respiratory condition, this study aimed to investigate the effect of sensory stimulation provided by family on arterial blood oxygen saturation in critical care patients. MATERIALS AND METHODS: This study is a clinical trial conducted on 64 patients hospitalized in the ICU wards of Al-Zahra and Kashani hospitals in Isfahan, Iran in 2012 and 2013. The patients were selected by simple sampling method and were randomly assigned to two groups (study and control). Patients' arterial blood oxygen saturations were measured 10 min before, immediately after, 10 min and 30 min after sensory stimulation in the study group, and simultaneously in the control group without any intervention. RESULTS: Repeated measures analysis of variance (ANOVA) showed a significant difference in the mean of arterial blood oxygen saturation levels 10 min before, immediately after, 10 min and 30 min after sensory stimulation in the study group (P < 0.001), but in the control group, the difference was not significant (P = 0.8). Pair wise comparison of the mean arterial blood oxygen saturation levels at different time points by Fisher's Least Significant Difference (LSD) showed that there was a significant difference in the intervention group (P < 0.022). But in the control group, there was no significant difference between pairs of time points (P > 0.18). CONCLUSIONS: Application of sensory stimulations as a nursing and non-medical intervention by the family members improves comfort and increases the level of blood oxygen saturation in critical care patients.

An epidemiologic study of burns: Standards of care and patients' outcomes.

BACKGROUND: Many people suffer from burn injuries every year, and burns make the patients undergo surgeries and years of rehabilitation. Burns lead to more years of disability, compared to cancer or heart diseases. Epidemiologic studies are needed to reveal the span, impact, and related factors of burns to help take appropriate efforts to reduce its mortality and morbidity. MATERIALS AND METHODS: This study was conducted in two phases. The first phase was a descriptive retrospective study conducted on 836 burn patients who were admitted to the main special burn hospital of Isfahan, Iran. Data were collected from archived patients' files using a checklist approved by the faculties of epidemiology and nursing. In the second phase, a survey was done based on the professional task checklist of burn ward nurses to assess the fulfillment of each task by the nurses. RESULTS: Burns were found to occur more among those in the age groups of 20-30 (26.2%) and 0-10 years (22.9%). The most common causes of burns were flammables and gas explosions due to imprudence at home and workplaces, or self-infliction. Mortality rate was 21.7% due to sepsis, shock, and inhalation injuries, respectively. Nurses gave 19.78 out of 50 points (39.56%) to their performance in the prevention of sepsis. CONCLUSIONS: Based on the findings of this study, it can be concluded that there is still an increasing need for safety education and using environmental safety measures, as well as developing high-quality methods to transport burn patients and administer care to decrease the mortality and morbidity associated with burns.

The effect of a care program on pain intensity of cancer patients who underwent surgery and hospitalized in Sayyed-Al-Shohada Hospital of Isfahan University of Medical Sciences in 2011.

INTRODUCTION: One of the most frequent issues nurses encounter with after or during cancer-related surgeries is pain. For postoperative pain relief, different nonpharmacologic interventions, such as nurse-patient communication, mental support, preoperative education, and consultation can be used. Doing such interventions may decrease postoperative pain. However, the research results regarding the effect of such measurements on pain intensity is contradictory. So in this research study the effect of a pain management plan on pain intensity after cancer surgery was assessed. MATERIALS AND METHODS: The present study is a pre- and posttest case and control clinical trial, which was conducted in Sayyed-Al-Shohada Hospital of Isfahan University of Medical Sciences in 2011. Care program consisted of pain education, communication with the patient, and pain measurement. Seventy patients were sampled based on the inclusion criteria and randomly assigned in 2 groups. Data were collected using American Pain Society-patient outcome questionnaire, which measured pain intensity. RESULTS: In the experimental group, the mean score of pain intensity before surgery and in the first 12-24 h after surgery was less than the control group. Also comparing pain intensity mean differences before and in the first 12 h, before and in the first 24 h indicated that the experimental group had lower scores than the control group, but these differences were not statistically significant. In both the groups, in the first 24 h following surgery the mean score of pain intensity decreased significantly. DISCUSSION: Results of the present research study suggested that a nursing pain management program consisting consultation, education, and pain assessment may have a clinical effect on cancer patient pain intensity following surgery. However, these results were not statistically significant. This might be due to the limited sample size as well as conducting the program in a short period of time. It is recommended that effects of such a program on the pain intensity will be examined further with a larger sample and in a longer period of time.

The association between following transportation standards of the burned patients referred to Imam Mosakazem Hospital and the caused early complications in 2011.

BACKGROUND AND GOAL: Burn is an irreparable event, which results in numerous physical, psychological, social, and economic complications. The burned patients should be merely treated in a professional burn center due to vast clinical range of these patients. Since, a percentage of mortality in burned patients is for the patients' transportation from other centers; this study has aimed to investigate the manner of their transportation to Imam Mosa Kazem Hospital. MATERIALS AND METHODS: This is a descriptive cross-sectional study on 98 subjects selected through sequential sampling from thermally burned patients being referred to Isfahan burn emergency center by ambulance from August 2011 to November 2011. The data including demographic information and event details, burned surface, burning grade and the province of origin were collected by a questionnaire, as well as a checklist related to caring team standards, transportation team, transportation equipment, and outcomes. The data were analyzed by descriptive statistical tests. RESULTS: Based on the findings, the longest transportation time was 6.35 (4.30) hours. There was no significant association between patients' O2intake and hypoxemia. There was no association between patients' hypothermia and cooling the burn in the patients at the event location. There was a significant association between intake of fluid within transportation and urine output and hypovolemia (P = 0.00). Most of the defects of treatment were related to the equipments and infection control devices. DISCUSSION: The findings showed that burned patients' transportation is so far from standards in Iran, and the authorities' should pay specific attention to that in form of vast national investigations.

Study on effect of massage therapy on pain severity in orthopedic patients.

BACKGROUND: Pain as a main social problem has involved millions of people. Usually pharmaceutical methods use for treating pain but they have side effects which make them less effective. Massage is one of the effective ways for reducing pain after surgery. The aim of this study was to evaluate the effect of massage therapy on pain severity in orthopedic patients. METHODS: This is a clinical trial study on 60 arthroscopic knee surgery patients who were hospitalized in men's orthopedic ward of Al-Zahra and Kashani hospitals. A two part questionnaire was used for collecting data. Samples were selected using easy continuity method and then they were randomly divided into two groups. In intervention group, besides routine treatments, patients were massaged by the researcher for 20 minutes each day and pain severity was evaluated before and after the massage. Data was analyzed using descriptive and inferential statistics and SPSS software. RESULTS: Results showed that there was a meaningful different between mean score of pain severity before and after the massage in intervention group (p < 0.001) but this difference wasn't meaningful in control group (p = 0.32). Also comparing the mean score of pain severity in both groups before any interventions showed that there were no meaningful differences (p = 0.34) but this difference was meaningful after interventions (p = 0.001). CONCLUSIONS: Considering massage as a safe and effective intervention, it could be used as an easy, cheap and executable method for treating pain in all medical health care centers and even at patient's home.

Comparison of healing time of the 2 degree burn wounds with two dressing methods of fundermol herbal ointment and 1% silver sulfadiazine cream.

BACKGROUND: Burn wounds are one of the health problems in modern societies that are associated with irreparable harms and many side problems for patients and their families. Infection due to burn wounds is the main cause of death in such patients. One of the methods to prevent infection of burn wounds is topical antibiotic ointments. This study aimed to investigate and identify effective ointments to treat burn wounds. For this purpose, the effects of two types of ointment, fundermol and 1% silver sulfadiazine cream on second degree burn wounds were compared. METHODS: This was a clinical trial study conducted in 2008. Using convenient and continuous sampling method, 50 patients referred to Imam Mousa Kazem Burn Injury Clinic in Isfahan, Iran with 2(nd) degree burn wounds in 1% to 10% surface area were enrolled. The patients were randomly divided into two groups of treatment with fundermol and sulfadiazine and the dressing was changed once a day. The healing time for burn wounds in each patient was recorded in a checklist and data were analyzed by independent t-test via SPSS software. RESULTS: The healing time of burn wounds in the group treated with fundermol was shorter than that in the group treated with sulfadiazine (p < 0.001). CONCLUSIONS: The present study showed that fundermol ointment accelerates burn wound healing. Therefore, fundermol can be introduced as a good replacement for current treatments of burn wounds.