The effect of training and awareness of subtle control on the frequency of hand hygiene among intensive care unit nurses.

OBJECTIVE: This study aimed to determine the effect of awareness of subtle control after training on the hand hygiene compliance among nurses in intensive care units (ICUs). The study was conducted in two ICUs of a trauma center in Shiraz, Iran on 48 nurses. The nurses of one ICU were randomly allocated to the intervention and the nurses of the other ICU were allocated to the control group. All nurses were trained on hand hygiene. Then a fake closed camera television (CCTV) was visibly installed in the intervention group's ICU, while the nurses were aware of it. The degree of compliance with hand hygiene was observed in both groups before and after the intervention. Data were gathered using a checklist based on the World Health Organization hand hygiene protocol and analyzed using SPSS 16 and the Chi square, Wilcoxon, Mann-Whitney U, and Independent T-tests, were performed. RESULTS: The mean percentage of hand hygiene compliance in the intervention group after the intervention was significantly higher than before the intervention (p < 0.001). Additionally, the changes in the mean percentage of the intervention group was significantly higher than that for the control group (p = 0.001). The findings showed that a fake CCTV after training, installed in ICUs, can improve hand hygiene compliance.

Comparison of the Effect of Acupressure and Pilates-Based Exercises on Sleep Quality of Postmenopausal Women: A Randomized Controlled Trial.

BACKGROUND: Postmenopausal women experience a variety of symptoms, among which sleep disorder is one of the most common problems. Acupressure and Pilates exercise programs are effective nonpharmaceutical treatments which can improve sleep quality. In the present study, we aimed to compare the effects of acupressure and Pilates-based exercises on the sleep quality of postmenopausal women referred to medical clinics. MATERIALS AND METHODS: In this single-blinded randomized controlled clinical trial, we recruited 108 women aged 40-60 years who were randomly assigned into one control and two intervention groups using balanced block randomization method (three groups of 36 each). The patients in the Pilates exercise group participated in an exercise training program of three 1-hour sessions per week for 6 consecutive weeks. The participants of acupressure group received acupressure intervention three times a week for 6 weeks. The sleep quality of all participants was assessed and recorded using the Pittsburgh Sleep Quality Index (PSQI) once before and once after the intervention. RESULTS: The results showed no statistically significant difference among the three groups on the total scores of sleep quality after the intervention. The intragroup comparison revealed that the changes in the mean total scores were significant in both the intervention groups (P < 0.001) but not in the control group (P = 0.76). CONCLUSIONS: Pilates-based exercises and acupressure can effectively improve women's sleep quality. Both techniques can be applied as effective alternative and complementary methods for improving sleep quality during the postmenopausal period.

The effect of nurse-led care on stability time in therapeutic range of INR in ischemic stroke patients receiving warfarin.

PURPOSE: The current study is designed in order to investigate the effect of nurse-led care (the supportive and educational measurements by nurses) on stability time in therapeutic range of INR in ischemic stroke patients receiving Warfarin. METHOD: In this quasi-experimental study, 80 ischemic stroke patients were investigated, 40 patients in experimental group and 40 in the control group referred to the nurse-based warfarin clinics affiliated to Shiraz University of Medical Sciences. The mean±SD duration of the intervention was 144±84days. The patients based on the percentage stability time in the therapeutic range of INR were classified into 3 groups of good control (>75%), medium control (60-75%), and poor control groups (<60%). The results were analyzed using qui-square and independent t-test according to these categories. RESULTS: 38 patients in the experimental group and 39 in the control group had the therapeutic range of INR 2-3. The percentage of the stability time in the therapeutic range of INR (mean±SD) in the experimental group was 64.08%±18.7 and in the control group it was 44.58%±25.12 (P<0.001). The percentage of total INRs within the therapeutic range was 52.5% in the experimental group and 40.6% in the control group (P=0.001). CONCLUSIONS: In conclusion, using the stroke prevention guidelines, thrombotic therapy protocols and familiarity with patients' diagnosis and risk factors in the experimental group led to more patients' stability time (The time that patients could remain stable within the INR therapeutic range) in their therapeutic range of INR as the best indicator of clinical performance.

Assessment of the validity and reliability of a questionnaire on knowledge and attitude of general practitioners about andropause.

BACKGROUND AND OBJECTIVE: Andropause is one of the clinical and biochemical syndromes in aging men associated with the decrease in serum testosterone levels. With the increase in aging male population, life span in Iran, and focus on quality of life, andropause will become a major health issue that needs to be addressed in order to prevent disability. General practitioners, as the first level of health care providers, are in the best position to assess their knowledge and attitude about andropause period, so a structured instrument is necessary to assess them. This study aimed at the assessment of the validity and reliability of the self-made questionnaire on knowledge and attitude of general practitioners about andropause. METHOD: This is a descriptive study done on 402 general physicians working in public and private sectors. The instrument used was a self-administered questionnaire that was developed based on the literature review and recourses available on andropause and was designed to find out the level of knowledge and attitude of andropause. In order to determine the content and face validity of the questionnaire, judgments of experts were used. Cronbach's coefficient was used to determine the reliability of the questionnaire. SPSS 18 (SPSS Inc, Chicago, IL) was used to analyze the data. RESULTS: Content and face validity of the questionnaire was confirmed by experts. The reliability was confirmed by Cronbach's alpha of (0).895 for the part on knowledge and (0).839 for the part on attitude. CONCLUSION: Based on the results of the study, this questionnaire had appropriate validity and reliability to assess the knowledge and attitude of general practitioners about andropause.

Knowledge and Attitude about Andropause Among General Physicians in Shiraz, Iran 2014.

BACKGROUND: Andropause in men refers to the clinical and biochemical syndrome associated with advanced age and characterized by a deficiency in serum testosterone levels. With the increase in aging male population and life span in Iran and focus on quality of life, andropause will become a major health issue that needs to be addressed in order to prevent disability. The results of some research have shown that there is still low level of knowledge and attitude toward andropause among health professionals. This study aimed at assessing the level of knowledge and attitude of general physicians regarding andropause in 2014. METHODS: This cross-sectional study was carried out on 402 general physicians in Shiraz. A researcher-made questionnaire was developed for assessing the level of knowledge and attitude of general physicians about andropause. SPSS 18 was used to analyze the data, and descriptive statistics, ANOVA and Pearson correlation were applied for data analysis. RESULTS: The mean score of knowledge and attitude about andropause was 29.4 out of 76 and 35.1 out of 45, respectively. The findings showed a poor level of knowledge and positive attitude toward andropause among general physicians. There was a significant relationship between occupational status and knowledge about andropause (P<0.001). There was a statistically significant relationship between attitude and demographic characteristics (P<0.05). The correlation between knowledge and attitude toward andropause was not statistically significant (P=0.548). CONCLUSION: The findings of the present study indicate the need for designing educational interventions to improve the knowledge and attitude of andropause among general physicians.

Effect of head covering on phototherapy-induced hypocalcaemia in icterus newborns; a randomized controlled trial.

BACKGROUND: Although phototherapy has been used for more than 60 years it has some complications. The light waves produced from phototherapy reduce melatonin concentration in newborns with subsequent hypocalcemia. We aimed to assess the effect of head covering on calcium and magnesium levels in full term newborns during phototherapy. METHODS: In this randomized controlled trial, 72 full-term icterus newborns weighing >2500 gr with indirect hyperbillirubinemia who received phototherapy at the phototherapy ward of Moslemin Hospital, Shiraz, southwest Iran, during March to September 2010 were recruited and divided randomly into two groups. The neonates in the case group received phototherapy while wearing a hat, while phototherapy was performed without hats for the control group. The newborns were in perfect health during the tests. The calcium and magnesium levels of each newborn were tested at baseline, and 24 hours after phototherapy and 48 after treatment. The variables were compared using Student's t, Chi-square and repeat measurement tests. RESULTS: 14 (38.8%) newborns in the control group and 5 (13.8%) in the case group had hypocalcemia after phototherapy. A significant difference was found between the incidence of hypocalcemia in these two groups (P=0.03). However, magnesium levels did not change significantly (P>0.05). CONCLUSION: Phototherapy caused hypocalcemia but it had no effect on magnesium levels. This can be prevented by covering the head during phototherapy with no need for prophylactic administration of calcium. TRIAL REGISTRATION NUMBER: IRCT2013102315134N1.

Efficacy of penguin cap as scalp cooling system for prevention of alopecia in patients undergoing chemotherapy.

AIMS: The present study examines the efficacy of a scalp cooling system to prevent chemotherapy-induced alopecia in people with cancer. BACKGROUND: Alopecia has been established as the most distressing aspect of chemotherapy to such an extent that some patients even refrain from cytotoxic treatment. METHODS: Using a quasi-experimental approach in 2007, a total number of 63 patients aged 16-59 years (mean 35 ± 5·5 years) participated in the study and were treated with an intravenous regimen of chemotherapy drug. Thirty-one patients accepting the scalp-cooling system were compared for alopecia with 32 participants who refused it. Hair loss in the participants was evaluated by nurses using World Health Organization criteria at each cycle of chemotherapy. RESULTS: Using chi-square test differences between the two groups were statistically significant at cycles 2-6 (P < 0·05). Twenty-four participants (77·4%) of the study group were assessed as first and second grade of alopecia in the second cycle, whereas seven participants (22·6%) of this group exhibited third and fourth grade of alopecia. However, in the control group at the same cycle, 19 participants (61·3%) were assessed with third and fourth grade of alopecia. In the Sixth cycle 15 participants (50%) of the study group and 24 participants (75%) of the control group demonstrated third and fourth grade alopecia. CONCLUSION: A penguin cap can be an effective method to avoid alopecia in patients receiving chemotherapy drugs. However, it is important to bear in mind that because of individual characteristics, liver function and drug regimens it is not successful in all cases.