Effect of group hope therapy on self-efficacy of adolescents with type 1 diabetes.

OBJECTIVE: This study aims to determine the effect of group hope therapy on the self-efficacy of adolescents with type 1 diabetes. METHODS: This randomized clinical trial was conducted on 45 adolescent patients with type 1 diabetes in Iran. The subjects were randomly assigned into the intervention and control groups. The intervention group received eight 90-min sessions of group hope therapy using Snyder's method. RESULTS: The mean score of self-efficacies in the intervention group was significantly higher than the control group (p<0.05). CONCLUSION: The results of the study suggested that group hope therapy had a significant impact on self-efficacy of adolescents with type 1 diabetes but had no effect on academic self-efficacy and self-efficacy in blood glucose management.

The Relation between Different Aspects of Quality of Life with Coping Style in Adolescents with Thalassemia in Comparison to a Healthy Group.

Background: Thalassemia as a chronic disease could affect different aspects of a patient's life. On the other hand, when encountering the symptoms of a chronic disease as a stressful factor, the coping strategy of the adolescents and their families could have an important role in the quality of life of these patients. The present study was conducted to determine the relation between different aspects of quality of life with coping styles in the adolescents with thalassemia in comparison to a healthy control group. Materials and Methods: The present study is a case-control research in 2017. Studied samples were 200 adolescents with thalassemia and healthy adolescents. Data gathering tools were demographic characteristics checklist and the coping style and quality of life questionnaire by the World Health Organization. Data were analyzed by SPSS 20 using independent t-test, linear regression and correlation coefficients. Conclusion: Results of Pearson statistical test showed a positive and significant relation between the total mean score of quality of life and its physical, social and mental aspects with emotion-oriented coping style (p<0.01). Also a direct significant relation was observed between the total mean score of quality of life and its social and physical aspects with problem-oriented coping style(p<0.01). Conclusion: According to the results of the present study, educating the adolescents and their families for paying attention to the coping style for stressful factors and preparing these adolescents for passing toward the youth period, which could be challenging for them, are highly recommended.

Vancomycin Infusion Methods on Phlebitis Prevention in Children.

BACKGROUND: Hospitalized children require antibiotic therapy. The most common side effect of intravenous injections is Phlebitis. Due to high usage of Vancomycin in children and subsequent phlebitis in their intravenous lines, the current study aimed at comparing the effects of two intervention and routine vancomycin infusion methods in preventing phlebitis in hospitalized children. MATERIALS AND METHODS: The current study is a quasi-experimental study investigating 74 individuals between ages of 1 month and 6 years undergoing treatment using vancomycin. First, 37 children, hospitalized in internal medicine ward of Isfahan Paediatrics' Hospital, Iran with vancomycin infusion orders, were placed in control group, and another 37 children were placed in the intervention group through matching with control group. The intervention group used phlebitis prevention guidelines, created by the authors, while control group used routine infusion method of the hospital. Data were analyzed by SPSS software, and statistical significance was set at 5%. RESULTS: The occurrence of phlebitis was 45.90% in intervention and 89.10% in control group. Results showed that the frequency of phlebitis in intervention group was significantly lower than control group (χ2= 15.79, df = 1, p < 0.001) and the average time of phlebitis onset in control group was also significantly lower than that of the intervention group (t 72= 2.99, p = 0.004). CONCLUSIONS: According to the results, intervention vancomycin infusion method is more effective in reducing phlebitis as a result of intravenous catheter, compared to the routine vancomycin infusion method.

Investigating the Effect of Reflexology on the Breast Milk Volume of Preterm Infants' Mothers.

BACKGROUND: Reflexology is an interventional method which may lead to improved breast milk. Because the mechanism of milk production is complex, detailed research is required on the relationship between lactation and reflexology. Therefore, the aim of the present study was to determine the effect of reflexology on the volume of milk among mothers with premature infants. MATERIALS AND METHODS: This clinical trial was conducted among 50 mothers with premature infants in two groups of 25 patients admitted to the neonatal intensive care unit of Alzahra and Shahid Beheshti hospitals of Isfahan, Iran from August 2015 to November 2015. The patients were selected through convenience sampling method and divided into control and reflexology groups through random allocation. In the reflexology group, massage of the sole of the foot and foot was done in six sessions. The control group received regular breastfeeding training. Data were analyzed using descriptive and inferential statistics. RESULTS: Repeated-measures analysis of variance test indicated that the mean volume of breast milk in reflexology group (F = 44.002, p < 0.001) and control group (F = 43.09, p < 0.001) differed significantly at different times. Independent t-test showed that the mean increase in milk volume from day 1 to day 5 after the intervention compared to before the intervention was significantly higher in the reflexology group compared to the control group 1days after the intervention (t=5.25, p <0.001), 2 days after the intervention (t= 4.81, p <0.001), 3 days after the intervention (t=3.55, p =0.001), 4 days after the intervention (t= 2.98, p =0.004), 5 days after the intervention (t= 2.50, p =0.020). CONCLUSIONS: The results indicate that reflexology is effective on the volume of milk of mothers, and this low-cost and easy procedure can be used along with regular lactation training.

The Impact of an Interactive Computer Game on the Quality of Life of Children Undergoing Chemotherapy.

BACKGROUND: Quality of life (QOL) of children with cancer reduces right from the diagnosis of disease and the start of treatment. Computer games in medicine are utilized to interact with patients and to improve their health-related behaviors. This study aimed to investigate the effect of an interactive computer game on the QOL of children undergoing chemotherapy. MATERIALS AND METHODS: In this clinical trial, 64 children with cancer aged between 8 and12 years were selected through convenience sampling and randomly assigned to experimental or control group. The experimental group played a computer game for 3 hours a week for 4 consecutive weeks and the control group only received routine care. The data collection tool was the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module Child self-report designed for children aged between 8 to 12 years. Data were analyzed using descriptive and inferential statistics in SPSS software. RESULTS: Before intervention, there was no significant difference between the two groups in terms of mean total QOL score (p = 0.87). However, immediately after the intervention (p = 0.02) and 1 month after the intervention (p < 0.001), the overall mean QOL score was significantly higher in the intervention group than the control group. CONCLUSIONS: Based on the findings, computer games seem to be effective as a tool in influencing health-related behavior and improving the QOL of children undergoing chemotherapy. Therefore, according to the findings of this study, computer games can be used to improve the QOL of children undergoing chemotherapy.

Effect of Kangaroo Care Combined with Music on the Mother-premature Neonate Attachment: A Randomized Controlled Trial.

BACKGROUND: Premature birth may complicate the development and quality of the mother-infant attachment relationship. Music and kangaroo care are two common complementary cares performed in the neonatal intensive care unit (NICU). The present study investigated the effect of kangaroo care combined with music on the mother-premature neonate attachment. MATERIALS AND METHODS: In this clinical trial, 64 mothers with premature neonates were selected and assigned to the control and study groups through random allocation. In the control group, kangaroo care, and in the study group, kangaroo care combined with music was adopted. The level of mother-premature neonate attachment was measured and compared before and after the intervention in both the groups using Avant's Maternal Attachment Assessment Scale. RESULTS: There was a significant increase in the mean overall score of attachment in the kangaroo care combined with music group (70.72 (11.46)) after the intervention compared to the kangaroo care without music group (53.61 (9.76)). CONCLUSIONS: The mean overall score of mother-neonate attachment in the kangaroo care combined with music group was higher than the kangaroo care group. This difference can be related to the effectiveness of music combined with kangaroo care.

Effect of palady and cup feeding on premature neonates' weight gain and reaching full oral feeding time interval.

BACKGROUND: Premature neonates' feeding is of great importance due to its effective role in their growth. These neonates should reach an independent oral nutrition stage before being discharged from the Neonatal Intensive care Unit. Therefore, the researcher decided to conduct a study on the effect of palady and cup feeding on premature neonates' weight gain and their reaching full oral feeding time interval. MATERIALS AND METHODS: This is a clinical trial with a quantitative design conducted on 69 premature infants (gestational age between 29 and 32 weeks) who were assigned to cup (n = 34) and palady (n = 35) feeding groups through random allocation. The first feeding was administrated either by cup or palady method in each shift within seven sequential days (total of 21 cup and palady feedings). Then, the rest of feeding was administrated by gavage. RESULTS: Mean hospitalization time (cup = 39.01 and palady = 30.4; P < 0.001) and mean time interval to reach full oral feeding (cup = 33.7 and palady = 24.1; P < 0.001) were significantly lower in palady group compared to cup group. Mean weight changes of neonates 7 weeks after the intervention compared to those in the beginning of the intervention were significantly more in palady group compared to the cup group (cup = 146.7 and palady = 198.8; P < 0.001). CONCLUSIONS: The neonates in palady group reached full oral feeding earlier than those of cup group. Subjects' weight gain was also higher in palady group compared to the cup group. Premature neonates with over 30 weeks of gestational age and physiological stability can be fed by palady.

The implementation of kangaroo mother care and nurses' perspective of barriers in Iranian' NICUs.

BACKGROUND: Kangaroo mother care (KMC) is the most implementation intervention in caring of the infants, as in this method, both the mothers and infants are cared. The World Health Organization recommends implementation of KMC for all infants. However, there are some barriers in the way of its application. The purpose of this study was evaluation of the practical application of KMC and nurses' perspective about its implantation barriers in the neonatal intensive care units (NICUs) in Iran. MATERIALS AND METHODS: The descriptive study was conducted on 96 infants and 80 nurses working in the NICUs of two university hospitals in Isfahan, Iran. Data were collected by a two-section questionnaire and analyzed by t-test through SPSS 14. RESULTS: Study findings indicated that mean weight and age of the infants with KMC were 1510 g and 32 weeks, respectively. KMC was implantation for 32 min in a day. From nurses' perspective, mother-related barriers were the main barriers in the implantation of KMC as mothers were not present by their infants. Another barrier was the mothers' fear of touching their infants. In the domain of organizational barriers, physician's order was found to be the most important barrier in application of KMC. CONCLUSIONS: Identifying barriers in implantation of KMC is essential to support the mothers. Regarding mother-related barriers, organizational barriers, and the need for a physician's order for implementation of KMC, policy makers must provide facilities and equipment for applying KMC practice for mothers and improve the protocol of KMC in the NICU.

Effect of two polyethylene covers in prevention of hypothermia among premature neonates.

BACKGROUND: After the umbilical cord is cut, premature neonates face numerous problems including hypothermia. With regard to serious complications of hypothermia and incapability of conventional methods in preservation of neonates' temperature after admission, the researcher decided to conduct a study on the effects of two polyethylene covers in prevention of hypothermia among premature neonates. MATERIALS AND METHODS: This clinical trial was conducted on 96 neonates aged 28-32 weeks that randomly allocated, by drawing of lots, to three 32-subject groups as follows: Intervention group 1 (a plastic bag cover and a cotton hat), intervention group 2 (a plastic bag cover and a plastic hat), and a control group receiving routine care. Data were analyzed by descriptive and inferential statistics through SPSS V.14. RESULTS: Mean axillary temperatures in intervention groups 1 and 2 were different after admission and 1 and 2 h later, but this difference was not significant and the mean axillary temperature increased with time. Mean axillary temperature in the control group showed no significant difference at these time points and it did not increase with time. The mean temperatures in preterm infants were significantly higher in the intervention groups after admission and 1 and 2 h after birth, compared to the control group. Mean axillary temperature in intervention group 2 was significantly higher than in intervention group 1. CONCLUSIONS: Usage of a plastic bag cover and a plastic hat (with no risk of hyperthermia) is more effective in preventing hypothermia among neonates aged 28-32 weeks, compared to usage of a plastic bag cover and a cotton hat.

Effect of using static ultrasound technique on peripherally inserted central catheters' insertion success rate in neonates in a neonatal intensive care unit.

BACKGROUND: Peripheral insertion of central catheters can be difficult in neonates. We compared the success rates of peripherally inserted central catheters by two methods of using static ultrasound and traditional technique (vein visualization and palpation) in neonates. MATERIALS AND METHODS: In a prospective randomized, controlled trial, 52 neonates with birth weight lower than 1500 g in a level 3 neonatal intensive care unit were enrolled. Neonates were randomized to undergo peripherally inserted central catheter placement using a traditional technique (n = 27) versus static ultrasound-guided technique (n = 25). In the ultrasound group, vein localization was performed and the skin overlying the target vessel was marked. Insertion of catheter was then immediately performed. We recorded and compared success rates in the groups. RESULTS: Success rate after the first attempt was 68% in ultrasound group and 60% in traditional group. These rates for the second attempt were 50% and 40%, respectively. The overall success rates after two attempts were 84% and 76% in ultrasound and traditional groups, retrospectively (P = 0.24). CONCLUSIONS: There was no significant difference between the two groups regarding PICC success rates, probably because in the present study, most of the subjects were premature neonates whose vasculature was visually detectable.

Identification of perceived barriers of pain management in Iranian children: a qualitative study.

Hospitalized children are often inadequately treated for their pain. Paediatric nurses experience these inadequacies more than other health-care team members. This research was an attempt in the form of a phenomenological study to reveal some major barriers in children pain management as the nurses had perceived. Sixteen nurses were interviewed in the medical, surgical and infectious paediatric wards of a hospital in Iran. Data analysis were based on Colaizzi method that surfaced three main themes in different areas namely: organizational barriers, limitations relating to child's characteristics and barriers relating to the nature of disease and its treatments. The study results have shown organizational limitations added to the lack of authority for administering some medical intervention, inadequate equipment and utilities and unavailability of opioids as the main pain controlling and restricting factors. Additional factors that relate to the child specifications like age, temperament, behaviour, expression and gender affect the assessment and treatment of pain. The results revealed identified barriers in real context. It seems that some guidelines are needed to achieve optimal pain management.

Affective responses of the parents after diagnosis of type 1 diabetes in children.

BACKGROUND: These days, diabetes is deemed as one of the most important health and social-economic problems of the world. Since parents play a major role in treatment of diabetes, the most important part of managing diabetes is in the hands of the parents of children affected by diabetes. This special responsibility will increase the stress and family challenges and impacts parents' emotional responses. The affective reactions or responses of the parents can also be conveyed to the child himself and reduce self-care, increase glucose levels, increase the possibility of complications and reduce the quality of life. Thus, it is highly important to recognize the affective reactions of parents during various stages of the disease for the purpose of intervention. MATERIALS AND METHODS: All parents of children diagnosed with insulin-dependent diabetes who referred to Sedigheh-ye-Tahereh Endocrinology and Metabolism Research Center, Isfahan, Iran, were selected and the Symptom Checklist-90 (SCL-90) was filled in five stages (immediately, one month, three months, six months and twelve months after diagnosis). Convenient sampling was used to select 45 consecutive subjects out of whom 10 dropped out during the study. FINDINGS: The major problems of the study subjects at the beginning of diagnosis were depression, anxiety and physical problems, respectively. Three, six and twelve months later, they were depression, obsession and physical problems. Over time, the mean score of parents' affective reactions declined which indicated the acceptance of the disease by parents over time. CONCLUSIONS: In view of the fact that both mother and father of children with diabetes suffer from affective problems and since fathers refer to diabetes centers less than mothers, some decisions should be made to mentally support both fathers and mothers.

Impact of exercise on affective responses in female adolescents with type I diabetes.

BACKGROUND: Adolescent is a time of profound biologic, intellectual, psychological, and socioeconomic change that they will face a crisis. Therefore, compatibility may be exposed to many hazards, such as depression, anxiety, and other emotional problems. Nevertheless, a planned regular exercise enhances physical and mental health of adolescent female with diabetes. The aim of this study was to determine the effect of exercise on emotional reactions of female adolescents with type I diabetes. MATERIALS AND METHODS: This study was a quasi-experimental research conducted in Endocrine and Metabolism Research Centre. A total of 72 patients were randomly allocated in the two groups. The intervention group did aerobic exercise for 45 minutes, while the control group did not aerobic exercise. Data were collected using a Symptom Checklist (SCL)-90 questionnaire. Data were analyzed and using descriptive and inferential statistics methods and SPSS software. RESULTS: The results showed that the mean score for physical symptoms, depression, obsession-compulsion, interpersonal sensitivity, aggression, phobia, paranoid ideation, psychosis, and anxiety in the test group significantly decreased after intervention than before intervention. The average score in the control group did not differ. The average total score of emotional reactions in the test group after the intervention decreased before the intervention significantly (P = 0.001). However, in the control group, the mean scores did not differ (P = 0.97). CONCLUSION: The findings showed that regular exercise is effective on affective responses of adolescent females with type I diabetes.