The Effect of a Combined Exercise Program on the Fatigue Severity of Patients with Breast Cancer Undergoing Chemotherapy: A Randomized Clinical Trial Study.

Background: Breast Cancer (BC) is one of the most common cancers in the world, including in Iran. Chemotherapy as one of the basic treatments for BC leads to many side effects such as fatigue. This study aimed to examine the effect of a combined exercise program on the intensity of fatigue in patients with BC undergoing chemotherapy. Materials and Methods: This clinical trial study was conducted on 64 patients with BC undergoing chemotherapy referring to the Seyyed al-Shoada and the Al-Zahra clinics from January to April 2022. Eligible patients who met inclusion criteria were recruited by the convenience sampling and then assigned randomly to intervention and control groups. The combined exercise program in the intervention group was done for 8 weeks as three sessions a week (34 sessions) each for 35-40 min. Piper's Fatigue Scale was completed for both groups before and after the intervention. Data were analyzed using descriptive and inferential statistical methods. Results: The results showed that the mean score of fatigue intensity in both control and intervention groups had a statistically significant difference after the intervention (p = 0.004). The mean fatigue intensity score in the intervention group decreased significantly from mean (SD) 8.17 (1.88) to 5.56 (1.74). Conclusions: Based on the results, a combined exercise program can reduce fatigue in patients with BC. Therefore, nurses can utilize exercise programs and practices as a subset of complementary medicine alongside other treatment methods, which can effectively promote cancer patients' quality of life by reducing their fatigue.

Effects of Roy's Adaptation Model on Quality of Life in People with Opioid Abuse under Methadone Maintenance Treatment: A Randomized Trial.

Background: Opioid abuse is one of the most obvious problems in today's world and directly affects individuals' quality of life. The present study aimed to investigate the effects of Roy's adaptation model on the quality of life in people with opioid abuse under methadone maintenance treatment. Methods: This randomized trial study was conducted in 2021 on 72 patients with opioid abuse under methadone maintenance treatment at the Center for Addiction Harm Reduction in Isfahan. The samples were randomly allocated into intervention (n=36) and control groups (n=36) based on the table of random numbers by computer. The intervention was conducted by implementing Roy's adaptation model in the intervention group. To analyze the data, paired t-test, independent sample t-test, chi-square test, and analysis of covariance were used. Results: The mean ± standard deviation of the quality of life score in the intervention group (28.96±4.79) was significantly different than before the intervention (24.02±6.09) (P<0.001). At the same time, it was not significantly different in the control group. The mean ± standard deviation of the quality of life score in the intervention group (24.02±6.09) was not significantly different from the control group (20.55±8.53) before the intervention. Conclusion: Roy's adaptation model had positive effects on the quality of life score in patients with opioid abuse. On the other hand, patients' quality of life indicates the effectiveness of methadone maintenance treatment. Therefore, it is suggested to use this model in nursing care programs.

Health information-seeking behavior of nursing students in Isfahan city about COVID-19 disease.

BACKGROUND: The proper planning to help the health information-seeking behavior (HISB), as well as promoting its quantitative and qualitative level among nursing students increases educational efficiency and enables provide appropriate services to patients. The purpose of this study is to investigate the HISB of nursing students in the process of obtaining information about the emerging disease of COVID-19 in Isfahan city. MATERIALS AND METHOD: The present cross-sectional descriptive-analytical study was conducted in Isfahan´ s faculties of nursing and educational hospitals. The research sample included 448 students who met the inclusion criteria, using convenience sampling. Lenz's HISB questionnaire was used to collect information. Data were analyzed using Statistical Package for the Social Sciences statistical software version 20, using descriptive and inferential statistics, with confidence interval = 95%. RESULTS: The results indicate a statistically significant relationship between the age and marital status of students with the overall score of the HISB of nursing students (P < 0.05). Regarding the study, information was mostly obtained from "social media" (43.7%) although the participants more trusted in "health experts" (57.5%). The results of the present study indicated that the students often searched for "disease symptoms" (38.8%) and "epidemiological issues" (22.5%). DISCUSSION: "Internet sites and search engines" and "social media" provide quick access to information for users, which is one of the reasons for favoring these sources. However, they can be a platform for disseminating false and invalid information. Thus, other reliable sources such as the Ministry of Health and Medical Education should play a greater role in creating content on social media.

The Effect of Reducing the Fasting Time on Postoperative Pain in Orthopaedic Patients: A Randomized Controlled Trial.

BACKGROUND: Patients undergoing orthopedics surgery experience the most severe postoperative pain. The fasting time is a factor that affects this complication. The aim of this study was to investigate the impact of fasting time reduction by using oral carbohydrate on postoperative pain and analgesic consumption in orthopedic patients. MATERIALS AND METHODS: This randomized control trial was conducted between November 2017 and December 2018. Sixty-four patients were randomly assigned into the intervention (which consumed 200 mL of the 12.50% carbohydrate, 2 h before the surgery) and the control group (which was fasted from midnight). Postoperative pain was measured by visual analog scale; the amount of the consumed analgesics was also recorded. The data were analyzed by using Chi-square and t-test. RESULTS: The mean (SD) of the pain scores in the control group immediately and 2, 4, 6, 12 and 24 h after consciousness were 7.19 (2.64), 6.69 (2.17), 6.31 (2.05), 6.16 (2.08), 6.06 (2.24), and 5.38 (1.86), respectively. These scores for the intervention group were 7.44 (1.48), 6.31 (1.25), 5.72 (1.17), 5.59 (1.43), 5.25 (1.13), and 4.97 (1.57). The mean of the pain scores between two groups was not different (p > 0.05). The amount of the consumed morphine (t 61= -2.10, p = 0.039), pethidine (t 62= -2.25, p = 0.028), and diclofenac (t 62= -2.51, p = 0.015) were significantly different between the two groups. CONCLUSIONS: The pain intensity in the patients with shortened fasting time was lower, but it was not statistically significant. Moreover, reducing fasting time by using carbohydrate significantly reduced the use of analgesics.

The Relationship between Self-Compassion and the Experience of Memorial Symptoms in Patients with Gastrointestinal Cancer.

BACKGROUND: Patients with Gastrointestinal (GI) cancer experience a range of physical and psychological memorial symptoms after developing cancer and beginning to receive medical care. The present study was conducted to investigate the relationship between self-compassion and the experience of memorial symptoms in patients with GI cancer. MATERIALS AND METHODS: This descriptive-correlational study was conducted in July to August 2019. The study sample included 190 patients admitted to Seyed Al-Shohada Hospital, with GI cancer who entered the study by convenience sampling. Data were collected using a patient demographic information form, Neff's Self-Compassion Scale (SCS), and the Memorial Symptoms Assessment Scale (MSAS) and then analyzed by Pearson correlation coefficient in SPSS-20. RESULTS: The mean (SD) total score of self-compassion was 86.67 (16.65) out of 130, and the mean (SD) total score of memorial symptoms was 1.40 (0.64) out of 4 in patients with GI cancer. The most frequently reported physical symptom was lack of energy, with an 86.84% prevalence, and the most frequently reported psychological symptoms included worrying and feeling nervous, with 70.52% prevalence rates. The total score of self-compassion was inversely correlated with the total score of memorial symptoms, the score of psychological symptoms, and the score of physical symptoms. Furthermore, the total score of the memorial symptoms was inversely correlated with the scores of all the self-compassion components (p < 0.001). CONCLUSIONS: Cancer patients had memorial symptoms in both physical and psychological domains. These symptoms decrease with an increase in self-compassion, so compassion-based educational interventions by nurses can be used to reduce these symptoms.

Prevalence of Postoperative Nausea and Vomiting and Pain in Patients Undergoing Elective Orthopaedic Surgery in Iran.

PURPOSE: The purpose of this study is to determine the prevalence of postoperative nausea, vomiting, and pain and the severity of postoperative pain in adult patients undergoing elective orthopaedic surgery in Iran. DESIGN: A descriptive, cross-sectional study design was used. METHODS: One hundred twenty-eight patients undergoing elective orthopaedic surgery participated in the study. Demographic and surgical characteristics, severity of pain, frequency of postoperative nausea and vomiting, amount of analgesics and antiemetics administered were measured. FINDINGS: The mean time of surgery was 123.67 min. Of all patients, 59.3% experienced nausea and 39% had postoperative vomiting; 98.4% of participants experienced pain. The mean pain intensity in the first 24 hours after surgery was 6.3 based on the Visual Analogue Scale. CONCLUSION: High prevalence rates of postoperative nausea (59.3%) and vomiting (39%) were recorded. Among 98.4% of participants, pain intensity was rated as moderate during the first 24 hours after consciousness.

An investigation of the effects of therapeutic touch plan on acute chemotherapy-induced nausea in women with breast cancer in Isfahan, Iran, 2012-2013.

INTRODUCTION: Nausea is the worst and most prevalent chemotherapy-induced complication experienced by 70-80% of patients despite mediation therapy. Reduction of nausea is one of the most important roles of oncologist nurses. Today, complementary therapies in addition to classic medicine, because of their lower costs, receive much attention. Nonetheless, their safety and effectiveness are not yet proven. The purpose of this research was to investigate the effect of therapeutic touch plan as a complementary therapy on acute nausea in women with breast cancer in 2012-2013 in Isfahan, Iran. MATERIALS AND METHODS: A quasi-experimental, single-blind, randomized control trial with three groups (control, placebo and intervention) was performed at the Isfahan Seyedolshohada (AS) Teaching Hospital, Isfahan, in 2012-2013. The intervention was therapeutic touch plan on women with breast cancer, with the three groups receiving the same medicine regimen. Information was recorded by a checklist after infusion of chemotherapy drugs. Data analysis was performed by SPSS, ANOVA and Kruskal-Wallis tests. RESULTS: The ANOVA test showed that the therapeutic touch plan was significantly effective in reducing the duration of nausea compared with the control and placebo groups (P < 0.001). The Kruskal-Wallis test showed that the frequency of occurrence of nausea was also reduced in the intervention and placebo groups compared with the control group (P < 0.001). The therapeutic touch plan was significantly effective in delaying the onset of nausea compared with the control and placebo groups (P < 0.001). CONCLUSION: This research showed that the therapeutic touch plan is effective in reducing acute chemotherapy-induced nausea; thus, education and implementation of the therapeutic touch plan is proposed for clinical nurses.

Quality of life and related factors among the women undergoing mastectomy.

BACKGROUND: Breast cancer is the most common cancer among women and 81% of therapeutic surgery performed for breast cancer in Iran is mastectomy. Following mastectomy, the patients suffer from many problems which lead to several disorders and decrease in their quality of life (QOL). MATERIALS AND METHODS: This cross-sectional descriptive study was conducted on 105 breast cancer patients who underwent mastectomy, selected with a convenient sampling method. A questionnaire containing three parts was used to collect data. The data were analyzed by SPSS version 14 using descriptive and analytical statistical methods. RESULTS: Spearman test showed that there was a statistically significant relationship between QOL and education level and also fatigue. Moreover, Spearman test indicated a statistically significant correlation between age and the mental dimension of QOL. There was no significant relationship between QOL with marital and employment status. CONCLUSIONS: Based on the findings, we can suggest that nurses should be educated about the factors affecting QOL. They can receive the necessary knowledge in various areas such as meeting the patients, optimum management of patients' problems, improvement of their health, and finally help to increase the cancer patients' QOL.

Does spiritual care program affect levels of depression in patients with Leukemia? A randomized clinical trial.

BACKGROUND: Although 25-33% of patients with non-hematological malignancies suffer from depression disorder, some studies have reported the rate among patients with leukemia as high as 50%. Furthermore, based on studies chronic disease such as leukemia increases the patients' spiritual needs and may accelerate the patient problems. Therefore, spirituality has a significant role in adapting to leukemia and coping with its consequent mental disorders such as depression. Owing to the spirituality aspect importance and contradictory results of previous research, this study was hence performed to determine the effects of a spiritual care program on depression of patients with leukemia. MATERIALS AND METHODS: This randomized clinical trial was conducted in specialized cancer treatment center affiliated to Isfahan University of Medical Sciences (Isfahan, Iran). A total of 64 adult patients with leukemia were randomly divided into experiment and control groups. The spiritual care program including supportive presence and support for religious rituals was implemented for 3 days. Depression sub-scale of 42-item depression, anxiety and stress scale-42 was completed before and after the intervention for both groups. Data was analyzed using ANCOVA, Mann-Whitney U-test, Chi-square, in SPSS statistical software (version 18, SPSS Inc., Chicago, IL). RESULTS: After the intervention, mean score of depression was significantly lower in the experiment group than in the control group (P < 0.01). Comparison the mean score of depression in two groups, revealed the decrees in mean score of depression 11.09 (8.47) after spiritual care program that it was significant (P < 0.001). CONCLUSION: Our spiritual care program could successfully decrease depression level in patients with leukemia and nurses have to apply a holistic care approach with emphasis on spiritual care to decrease depression, so paid attention to spiritual aspect of patients accompanying with physical aspects in therapy process is recommended.

Factors affecting quality of life and fatigue in patients with leukemia under chemotherapy.

BACKGROUND: The goal of treating chronic diseases, including hematologic malignancies, is to increase patients' life span and to improve their capabilities as much as possible; so that patients could maintain an appropriate level of quality of life (QoL) and continue their lives. Most studies performed to evaluate the treatment of various diseases were mostly focused on the increase of life expectancy regardless of the QoL and treatment issues. Furthermore, fatigue is one of the most common and distressing side effects of cancer and treatments related to it, which can affect a patient's QoL, and be followed by many problems. This study was designed and implemented with the aim to determine the factors affecting the QoL and fatigue in patients with leukemia undergoing chemotherapy. MATERIALS AND METHODS: This was a cross-sectional correlation descriptive-analytical study. One hundred and fifteen patients with leukemia referred to Sayyed-Al-Shohada Hospital were enrolled in the study through convenient sampling method. To collect data, a three-part questionnaire was used: The first part was related to demographic characteristics and disease-related data and the second part was the fatigue check list and the third part was the Short-Form 36 Health Survey (SF-36) related to QoL. The data were analyzed after collection and coding through Software SPSS version 18 and descriptive and analytical statistics (analysis of variance test, independent t test, Pearson's and Spearman's correlation coefficient) with 95% confidence interval. RESULTS: The results showed that there was a significant correlation between QoL in Physical Component Summary with gender (P = 0.03), educational level (P = 0.09), and marital status (P = 0.004), Also there was a significant correlation between QoL in Mental Component Summary with educational level (P = 0.01) and economic status (P = 0.02). Findings showed that there was a significant correlation between fatigue and marital status (P = 0.005). But statistically there was no significant correlation between demographic variables such as age, educational level, and employment status with patients' fatigue. Spearman correlation coefficient showed that there was a significant correlation between fatigues with pain (P = 0.005). Also findings revealed the statistically significant correlation between fatigues with economic status (P = 0.003). CONCLUSION: According to the present results, it seems that some demographic factors affect QoL and significant relationship exists between them. Fatigue in patients with leukemia dramatically affects their QoL. Therefore, it is important for medical staff to pay attention to demographics and fatigue in leukemic patients in order to improve their QoL and help them to organize their activities to promote health and QoL.

Effect of a spiritual care program on levels of anxiety in patients with leukemia.

BACKGROUND: Leukemia is the most common and fatal cancer among young adults. Among all malignancies, it has the greatest effects on emotional and mental aspects of the patients. While 25-33% of patients with non-hematological malignancies suffer from anxiety disorder, some studies have reported the rate among patients with leukemia as high as 50%. Anxiety can negatively affect other important characteristics and parameters in patients with cancer. Furthermore, cancer increases the patients' spiritual needs. Therefore, spirituality has a significant role in adapting to leukemia and coping with its consequent mental disorders such as anxiety. This study was hence performed to determine the effects of a spiritual care program on anxiety of patients with leukemia. MATERIALS AND METHODS: This randomized clinical trial was conducted in Sayyed-Al-Shohada Hospital affiliated to Isfahan University of Medical Sciences (Isfahan, Iran) in 2012. Sixty four adult patients with leukemia were randomly divided into the experiment and control groups. The spiritual care program including supportive presence and support for religious rituals was implemented for 3 days. Anxiety subscale from the 42-item depression, anxiety and stress scale was completed before and after the intervention for both groups. Data was analyzed using descriptive and inferential statistical methods (Chi-square, paired and independent t-tests) in SPSS18. RESULTS: There was no significant difference between the two groups before the intervention. However, after the intervention, mean score of anxiety were significantly lower in the experiment group than in the control group (P < 0.01). There was also a significant difference in the scores of the experiment group before and after the intervention (P < 0.01). Such a difference was absent in the control group. CONCLUSIONS: Our spiritual care program could successfully decrease anxiety levels in patients with leukemia. Therefore, in cases of refractory diseases such as cancer, nurses have to apply a holistic care approach with emphasis on spiritual care.

Investigation of the SWB and its relation with demographic parameters in patients with breast cancer referred to an oncology hospital affiliated to the Isfahan university of medical sciences.

BACKGROUND: Spiritual well-being is well-recognized as a factor that affects cancer patients' quality of life, quality of care, and satisfaction. There is evidence that supports the fact that patients' spiritual needs are associated with better quality of care, higher hospice utilization, and less aggressive care at the end of life. However, few studies have examined the Spiritual well-being (SWB) in cancer patients. Less is known about spirituality; furthermore, no published research about SWB and its relationship with demographic parameters in breast cancer patients exists; this made us carry out this project. MATERIALS AND METHODS: This cross-sectional study was a descriptive - analytical one, conducted on 297 breast cancer patients, with a simple sampling methodology. The data collection instrument included a questionnaire containing two parts (demographic information and standard SWB Scale questionnaire). The data were analyzed with 95% confidence by SPSS18, using descriptive and analytic statistics. RESULTS: According to the results of the present study, SWB of most of the study subjects (52.52%) was at a moderate level. Results showed that the average score for religious aspect of spiritual well-being (RWB) was 51.38 ± 8.17 for 60, average score for the existential aspect of spiritual well-being (EWB) was 42.47 ± 10.21 for 60, and the total score of SWB was 93.69 ± 10.04 for 120. Based on the study findings, there was a statistically significant correlation between the SWB and age (P = 0.03, r = 0.59), educational level (P = 0.04, r = -0.58), and marital status (P = 0.001), of breast cancer patients. CONCLUSION: According to the results of the present study, the SWB of most study subjects was at a moderate level. Furthermore, according to the results there was a correlation between some important demographic parameters in women with breast cancer and SWB. Hence, it is necessary for the treatment team to assess and improve the SWB of patients; meanwhile the role of nurses is highlighted. In fact, the nurse is the first person who can recognize the spiritual needs of a patient and even his/her family, and can be effective in meeting the spiritual needs and improving their SWB. Therefore, it is strongly recommended that in patients with cancer, a holistic care plan, based on spiritual care, development, and education of patients be applied, as it is considered to improve their SWB.

Investigation the quality of life and its relation with clinical and demographic characteristics in women with breast cancer under chemotherapy.

BACKGROUND: This study was performed to examine quality of life's dimensions and its relationship with some clinical and demographic characteristics on women with breast cancer under chemotherapy referred to the oncology hospital, Isfahan University of medical sciences, Iran. METHODS: This Cross sectional study was conducted among 330 a descriptive-analytic one breast cancer patients with simple sampling methodology. Data collection instrument included a questionnaire contains 2 parts (clinical and demographic characteristics information and version 2.0 of the SF-36 questionnaire (the international version). The data were analyzed with 99% confidence by carried out using SPSS(18) with using descriptive and analytic statistics. RESULTS: The majority of subjects' quality of life was moderate (53.93%). there was a statistically significant relationship between quality of life among breast cancer patients with chemotherapy sessions (P < 0.05, df =4, χ(2) = 16.37). One way Analysis Of Variance (ANOVA) suggested the absence of any significant relationship between quality of life with marital status (f = 0.21; P = 0.92) and employment status (f = 0.26; P = 0.77). Also, Spearman test showed the absence of any significant relationship between quality of life with age (P = 0.60), and the elapsed duration from diagnosis (P = 0.68), however Spearman test showed significant relationship between quality of life and education status (P = 0.002, r = -0.84). CONCLUSION: This study showed a direct correlation with regard to results of this study, there was a direct correlation between the number of chemotherapy sessions and patients quality of life. The attitude of the population toward chemotherapy is usually inhibiting and negative, so patients, students and nurses should be trained about chemotherapy efficacy to improve their attitude about chemotherapy, which in turn would lead to improvement of the patients' quality of life.