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Given the moderate perception of nurses concerning futile care, and its negative impact on caring behaviors toward patients, implementing suitable interventions for minimizing the frequency of futile care and its resulting tension seems to be mandatory. It is imperative to train nurses on adjustment mechanisms and raise their awareness as to situations resulting in futile care.

Background: The number of patients with chronic renal failure is increasing in Iran. Quality of life is an important indicator that reveals the sense of well-being, positive understanding of their, and the effectiveness of health care in patients undergoing dialysis, which could be affected by duration of dialysis. Objectives: This study aimed at investigating the relationship between quality of life and duration of dialysis in hemodialysis patients. Methods: In this descriptive correlational study, 246 patients with chronic kidney failure were selected by Single-stage stratified cluster sampling. Hemodialysis patients were put into 2 groups with a duration of hemodialysis less than and more than 36 months and were then compared with each other. The quality of life was measured using the kidney disease quality of life short form (KDQOL-SF36). Data analysis was performed by the Pearson correlation coefficient, independent t-test, and ANOVA Results: The mean duration of hemodialysis patients was 34.03 months. There was no significant relationship between the quality of life in patients and duration of hemodialysis. Poor quality of life had a significant correlation with old age (P < 0.001), educational level (P < 0.001), job, and income (P < 0.001). Conclusions:The findings showed poor quality of life in patients on dialysis. The length of the disease and other accompanying diseases reduced the quality of life in dialysis patients as their age increased. It is evident that educated people who have better access to sources of support and are able to cope with disease complications have a higher quality of life.

BackgroundOcclusion of central venous catheters is one of the limiting factors in using them. Heparinized saline solution is the standard solution used for keeping the catheters open.ObjectivesThis study aimed to determine the effect of heparin saline solution and normal saline in maintenance of patency of central venous catheters.Patients and MethodsThis double-blind study was performed on 84 patients of intensive care unit who had central venous catheters. The patients were randomly divided into two groups of heparin saline receivers and normal saline receivers. In the heparin group after each drug injection into the lumen, 3 mL of heparin saline solution was injected in the catheter as well. The other group only received 10 mL of normal saline instead. The catheters were examined for blood return and flushing every eight hours for 21 days. Data was analyzed using SPSS software version 20 and descriptive and analytic statistics were studied.ResultsThere was no significant difference in the rate of flushing (P = 0.872) and possibility of taking blood samples from catheters (P = 0.745) in the two groups of heparin and normal saline receivers. Furthermore, using heparin had no effect on prolonging the survival of catheters.ConclusionsConsidering possible side effects of heparin and the increase in treatment charges and the fact that using heparin did not have a significant effect on patency and survival of catheters in the studied patients, it is recommended to use normal saline solution to maintain the patency of central venous catheters.

Background:Sleep disorders and depression, accompanied by reduced quality of life and increased mortality are the most common psychological problems in dialysis patients. This study was conducted with the aim to investigate depression and sleep quality and their association with some demographic and clinical factors in hemodialysis patients.Method:This descriptive-correlative study was conducted on 310 patients undergoing hemodialysis in 8 centers in educational hospitals in Mazandaran University of Medical Sciences. Data collection tools included a demographic questionnaire, Beck Depression Inventory, and Pittsburg Sleep Quality Index (PSQI). Statistical analysis was conducted using Chi-Square test and regression model.Results:Results obtained showed 44.8% depression in patients. Significant relationships were found between depression and increased blood phosphorus (P=0.002) and urea (P=0.001). Poor sleep quality was observed in 73.5% of hemodialysis patients, which was found significantly related to aging (P=0.048), female (P=0.04), and reduced frequency of weekly hemodialysis (P=0.035).Conclusion:Depression and poor sleep quality are two common factors in hemodialysis patients, but patients do not overtly show symptoms of these disorders.

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The increasing progress in medical and health sciences has enhanced patient survival over the years. However, increased longevity without quality of life in terminally ill patients has been a challenging issue for care providers, especially nurses, since they are required to determine the futility or effectiveness of treatments. Futile care refers to the provision of medical care with futile therapeutic outcomes for the patient. Interest in this phenomenon has grown rapidly over the years. In this study, we aimed to review and identify nurses’ perceptions of futile care, based on available scientific resources. In total, 135 articles were retrieved through searching scientific databases (with no time restrictions), using relevant English and Farsi keywords. Finally, 16 articles, which were aligned with the study objectives, were selected and evaluated in this study. Overlapping studies were excluded or integrated, based on the research team’s opinion. According to the literature, futile care cannot be easily defined in medical sciences, and ethical dilemmas surrounding this phenomenon are very complex. Considering the key role of nurses in patient care and end-of-life decision-making and their great influence on the attitudes of patients and their families, support and counseling services on medical futility and the surrounding ethical issues are necessary for these members of healthcare teams.

The aim of this study was to determine the relationship between quality of life with stress in the haemodialysis patients. This descriptive correlation study was done on 100 haemodialysis patients selected by consent method from Imam Khomeini and Fatemeh Zahra Hospitals in Sari/Iran from March 2008 to February 2009. Data were collected in questionnaire consisting of 3 sections (demographic feature, quality of life and stress) in three months. In the questionnaire, first, quality of life then stress in the patients was studied and the variables described. Then the relation between them was determined by statistical analysis. From the total number of 100 patients (53 men and 47 women) under study, 42% with partial comfortable life had moderate tension. Pearson correlation coefficient showed that there is a significant linear relationship with quality of life and degree of tension, (r = 0.802). That is with increase of tension, quality of life declines (p < 0.001). Also Pearson correlation coefficient indicated that there is positive correlation between the number of hemodialysis per week and the history of dialysis (p = 0.001). History of dialysis in 69% of the patients was 1-5 years and 74% of them were dialyzed in the morning trice a week. Findings showed that, with increase of stress, quality of such patients' life decreases. Therefore, the nurses and the other members of medication team should know to reduce the patient's stress using the supportive procedures and adaptation techniques, help improve quality of life by proper intervention method.