The Effects of Spiritual Care on Fatigue and Pain among Patients with Cancer Receiving Chemotherapy: A Randomized Controlled Trial.

This study aimed at assessing the effects of spiritual care (SC) on fatigue and pain among patients with cancer receiving chemotherapy. This randomized controlled trial was conducted in 2018. Participants were 145 patients with cancer consecutively recruited from a large-scale public hospital in Zanjan, Iran, and randomly allocated to an intervention (n = 72) group and a control (n = 73) group through block randomization. Participants in the intervention group received SC for 3 days. The Fatigue Severity Scale and a visual analog scale were, respectively, used for fatigue and pain assessments before and after the study intervention. Chi-square test and the independent t test as well as the analysis of covariance were employed to analyze the data. The pretest mean score of fatigue was 5.18 ± 1.36 in the intervention group and 5.03 ± 1.29 in the control group with no significant between-group difference (P = .529). The posttest mean score of fatigue was 3.75 ± 1.05 in the intervention group and 4.80 ± 1.16 in the control group and the between-group difference was significant (P < .001). The pretest mean score of cancer-related pain in these groups was 2.64 ± 0.98 and 2.46 ± 1.22, which changed to 1.51 ± 1.006 and 2.32 ± 1.70, respectively, at posttest. The between-group difference respecting the mean score of pain was insignificant at pretest (P = .389) and significant at posttest (P = .001). Spiritual care is effective in significantly reducing fatigue and pain among patients with cancer receiving chemotherapy. Nurses and other health care providers can use SC to manage fatigue and pain of patients with cancer.

Prevalence of Depression, Anxiety and Stress Among Patients Discharged from Critical Care Units.

INTRODUCTION: The widespread use of advanced technology and invasive intervention creates many psychological problems for hospitalized patients; it is especially common in critical care units. METHODS: This cross-sectional study was conducted on 310 patients hospitalized in critical care units, using a non-probability sampling method. Data were collected using depression, anxiety, and stress scale (DASS-21) one month after discharge from the hospital. Data analysis was performed using descriptive and inferential statistics. RESULTS: 181 males and 129 females with a mean age (SD) of 55.11(1.62) years were enrolled in the study. The prevalence of depression, anxiety and stress were 46.5, 53.6 and 57.8% respectively, and the depression, anxiety and stress mean (SD) scores were 16.15(1.40), 18.57(1.46), 19.69(1.48), respectively. A statistically significant association was reported between depression, anxiety and stress with an increase in age, the number of children, occupation, education, length of hospital stay, use of mechanical ventilation, type of the critical care unit, and drug abuse. CONCLUSION: The prevalence of depression, anxiety and stress in patients discharged from critical care units was high. Therefore, crucial decisions should be made to reduce depression, anxiety and stress in patients discharged from critical care units by educational strategies, identifying vulnerable patients and their preparation before invasive diagnostic-treatment procedures.

Effects of triple combination of hydrocortisone, thiamine, and Vitamin C on clinical outcome in patients with septic shock: A single-center randomized controlled trial.

BACKGROUND: Recent studies suggest that hydrocortisone, Vitamin C, and thiamine alone or in combination may improve the clinical outcomes of patients with septic shock. The aim of this study is the effects of this combination therapy on clinical outcome and sepsis biomarkers in patients with septic shock. MATERIALS AND METHODS: Fifty-eight consecutive patients suffering septic shock were randomly assigned into two groups receiving the combination therapy of hydrocortisone (50 mg/6 h, intravenously), Vitamin C (1.5 g/6 h in 100 ml normal saline or DW5%, intravenously), and thiamine (200 mg/12 h in 50 ml normal saline or DW5%, intravenously) or placebo for up to 4 days. RESULTS: The decline in procalcitonin, lactate, and leukocyte count 72 h after the initiation of treatment was significantly greater in the intervention as compared to the control group. The intervention group has a significantly lower sequential organ failure assessment score 72 h after treatment (P < 0.001). The mean duration of vasopressor dependency was shorter in the intervention group (P = 0.039). In-hospital death occurred in 10.3% of the patients who received combination therapy and 37.9% in the control group (P = 0.014). CONCLUSION: The administration of the triple combination of hydrocortisone, thiamine, and Vitamin C appeared to be effective in improving the clinical outcomes of patients with septic shock and of reducing vasopressor requirements with a significant increase in the rate of improvement of sepsis biomarkers.