Background:The long-term complications of hemodialysis deteriorate patients' quality of life and lead to physical and mental discomfort. Physiologically, sports activities can play an important role in reducing these side effects including muscle cramps. Objectives: The aim of this study was, to determine the impact of isotonic exercise on the frequency of muscle cramps. Methods: This clinical trial was carried out on 60 hemodialysis patients admitted to the dialysis units of Shahrekord and Borujen hospitals in 2014. The intervention included an isotonic exercise program that was implemented during 10 sessions of constant cycling (each lasting 10 minutes) immediately before dialysis. The outcome variable was the number of muscle cramps in patients during the hemodialysis session. The data were analyzed in SPSS-16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential tests (independent and paired t-tests). Results: The mean frequency of leg cramps before the intervention was not significantly different between the two groups (P = 0.10). However, it was significantly different between the groups after the intervention (P = 0.001). Moreover, the number of muscle cramps in the experimental group was significantly lower after the intervention than before implementing the program (P = 0.03).
Conclusions:The isotonic exercise of constant cycling has a considerable effect on decreasing the number of muscle cramps in hemodialysis patients. Hence, it is suggested that dialysis units provide facilities for constant walking and cycling to accelerate patients' treatment.
Introduction: Prevention and management of pain is one of the major challenges in the neonate intensive care units. The aim of this study was to evaluate the effect of breast-milk and leg massage on the intensity pain from painful procedures such as heel stick.
Methods: This study was a randomized clinical trial aimed to compare the effect of breast-milk and leg massage on neonate’s pain intensity during heel-blood sampling in neonatal care unit of Tehran Fayazbakhsh Hospital, Iran in 2016. Neonates were divided into two groups of 15, based on randomly number schedule. In the first group, first massage, then heel stick was performed, after 12 hours of wash out period, breast feeding intervention was performed and then blood sampling was done from the other heel. In the second group, the intervention group, the action had done opposite. The neonates were laid in the supine or lateral position, at the same time as bleeding was started, filming of the faces and organs of the infant was carried out by a researcher's colleague and it continued only two minutes after the bleeding was completed.Videos were viewed by two senior specialist babies and the pain intensity was determined based on the NIPS scale. The data were fed into the SPSS 20 software and descriptive and analytic statistics were applied for data analysis.
Results: The mean of the statistical Wilcoxon signed Ranks Test showed that there was a significant difference for pain score during (p<0/001), and after the intervention of each of the two groups (p<0/0001).
Conclusion: Based on the result of study, nurses can use leg massage to decrease the pain during painful procedures relevant to newborns instead of breast-milk.
Background:Supervisors should have certain characteristics and adequate preparation for their roles. Yet, there are no well-educated experts knowing about the supervisor's role and responsibilities and how to train them. So, this research was conducted with the purpose of finding the factors affecting nursing supervisor training.Materials and Methods:This research is an inductive content analysis. Participants were 25 in number, consisting of nurses and supervisors in Shahid Sadoughi University hospitals. The participants were chosen by a purposive sampling method. Data collection was done by semi-structured interviews and reviewing documents. Data were analyzed using conventional content analysis.Results:Findings included two main themes: Firstly, establishment of a supervisory infrastructure that includes “making the appointments and retention of supervisors, clarifying the duties and authority of supervisor, developing supervisory culture, specializing supervision, and conducting practice-based training” and secondly, comprehensive supervisory competencies that include “acquiring scientific, managing, communicative, professional, ethical, pedagogical, and supporting adequacy.”Conclusions:Clinical supervisor has a major role in ensuring the quality of nursing care. This leads to improvements in patient care and nurses’ personal and professional development. So, it is necessary that for effective supervision in nursing, first an infrastructure is provided for supervision and then the comprehensive competency of a supervisor is enhanced to apply effective supervision.
Introdution: Newborn individualized developmental care and assessment program (NIDCAP) is emphasized. This study aimed to determining the barriers to implementation of NIDCAP from nurses' perspectives in neonatal intensive care units in Shahid Sadoughi Hospital in Yazd.
Methods: This descriptive study was conducted using a census sampling method. The samples were54 nurses working in the intensive care unit of Shahid Sadoughi and Afshar Hospitals in Yazd. Data were gathered using two questionnaires,( demographic and barrier assessment questionnaires) . Data analysis was performed in SPSS version 24 using descriptive statistics, Chi-square, independent t-test and fisher test.
Results: Results showed that in terms of mean and standard deviation, in the area barriers of sleep care, lack of skill (3.08± 1.28 ), In the area of pain and stress assessment management, lack of skill (2.86. ±1.31), in the area of activities of daily living and family-centered care, lack of effective communication with parents respectively (2.83 ± 1.39) and ( 2.86± 1.32), in the area of provision of healing environment, lack of standard light and sound in unit (2.76 ± 1.81) and in the area of organizational barriers, the disproportionate number of nurses to the patients (3.47±0.84) were identified as the most important barriers
Conclusion: Based on the findings, lack of skill, lack of effective communication with parents, lack of standard environment and disproportionate number of nurses and patients are the most important barriers to the implementation of NIDCAP in NICUs that managers need to plan appropriate design for addressing them.
Impact of a designed isotonic exercise program on pain intensity of muscle cramps in legs of patients undergoing hemodialysis; a randomized clinical trial
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