@article{ author = {Hoseinzadeh, Leila and Tabarsi, Beheshteh and Salehi, Shiv}, title = {The Relationship between Fatigue Severity and Shortness of Breath with Arterial Blood Oxygen Saturation in COVID-19 Patients: A Cross-sectional Study}, abstract ={Background & aim: Fatigue and shortness of breath are the main complaints of patients after COVID-19 disease, and determining the factors associated with them is of high importance for effective care of these patients. The aim of this study was to investigate the relationship between fatigue severity and shortness of breath with arterial blood oxygen saturation (SPO2) in COVID-19 patients. Methods: The present study was a cross-sectional study. In order to carry the study, 193 patients with COVID-19 admitted to Fatemeh Al-Zahra and Lolagar hospitals in Tehran in the second half of 2021 were selected through convenience sampling method. Demographic information questionnaire, fatigue severity scale, Modified Borg Dyspnoea Scale and recording SPO2 form were used to collect data. Data were analyzed using SPSS26 statistical software using statistical tests. Results: In total, 56.5% of the patients were women, 72% were married, 40.9% were housewives and 82.9% were over 40 years old. Patients' fatigue intensity (35 ± 17.55) was low, arterial blood oxygen saturation (89.74 ± 5.35) and patients' shortness of breath (3.35 ± 2.03) were at the level of light activity. Based on the results, the relationship between fatigue intensity and oxygen saturation was not significant (P = 0.246). There was a significant negative relationship between the severity of shortness of breath and SPO2 (P = 0.005, r = -0.202). As the severity of shortness of breath increased, the SPO2 decreased. Conclusion: The fatigue severity in patients with COVID-19 was moderate and the severity of shortness of breath was high, which should be given more attention as a traumatic complication. Also, due to the significant relationship between the severity of shortness of breath and arterial blood oxygen saturation, it is necessary for nurses caring for these patients to be reminded of the importance of measuring oxygen levels to seek the help of nurses and physicians in emergencies.}, Keywords = {Fatigue, Shortness of Breath, SPO2, COVID-19}, volume = {15}, Number = {2}, pages = {1-11}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.15.2.1}, url = {http://jccnursing.com/article-1-608-en.html}, eprint = {http://jccnursing.com/article-1-608-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2022} } @article{ author = {Nazari, Roghieh and Salehpooremran, Mohammad and SharifNia, Hamid and Goudarzian, Amir Hossein and Pourkia, Roghieh}, title = {Psychometric Properties of the Persian Version of the General Health Questionnaire in Patients with Mitral Valve Prolapse: A Methodological Study}, abstract ={Background and aim: Mitral Valve Prolapse (MVP) is one of the most common psychosomatic syndromes in human beings. The general health of patients with chronic diseases is important for health care providers. Since a valid tool is needed for general health assessments, this study was conducted in order to investigate the validity of the General Health Questionnaire-28 (GHQ-28) in patients with MVP. Methods: Construct validity was performed on 190 patients with MVP.  Factors were extracted with exploratory factor analysis with maximum likelihood and Promax rotation method. Then, 190 patients with other MVP were studied for confirmatory factor analysis and the model fitness was evaluated. Results: Exploratory factor analysis after the removal of seven items showed a four-factor construct for GHQ-28. Four factor were depressive symptoms, physical symptoms, social functioning and anxiety symptoms, respectively.  These four factors explain 47.9% of the total variance of the general health in patients with MVP. Due to that fact that all the regression coefficients in confirmatory factor analysis models and fitness indices of confirmatory factor analysis were high (>0.5), the assumed model had a good fit. Cronbach's alpha, omega McDonald, CR and the maximum reliability of the four factors extracted from the 21-item GHQ were greater than 0.7. Conclusion: Based on the study results, the validity and confidence of the 21-item Persian version of the GHQ has been confirmed. This tool can be used in screening and clinical studies related to the general health dimensions of patients with MVP.}, Keywords = {Psychometrics, General Health Questionnaire, Mitral Valve Prolapse}, volume = {15}, Number = {2}, pages = {12-22}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/15.2.12}, url = {http://jccnursing.com/article-1-620-en.html}, eprint = {http://jccnursing.com/article-1-620-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2022} } @article{ author = {Soheili, Soraya and Peyghambardoost, Razieh}, title = {Evaluation of Quality of Life and Variables Affecting its Prediction in Patients undergoing Hemodialysis in Hojjat Koohkamari Hospital in 2021: A Cross-sectional Study}, abstract ={Background and aim: Chronic renal failure and hemodialysis cause major changes in the quality of life of patients. This study was performed in order to evaluate quality of life and variables affecting its prediction in patients undergoing hemodialysis in Hojjat Koohkamari Hospital in 2021. Methods: The present study is a cross-sectional study performed on 104 hemodialysis patients over 18 years of age in Marand in 2021. Patients were selected by full census sampling.  Data collection tools included a demographic information checklist and a standard quality of life questionnaire for kidney patients. Results: The results showed that the overall quality of life score of dialysis patients was 52.7±23.1, which indicates the average level of quality of life of these patients. Pearson correlation coefficient showed that with age, the quality of life of the samples decreased (p=0.004, r=-31). Also, one-way analysis of variance showed a significant relationship between quality of life and income (p=0.02) and level of education (p=0.001) and duration of dialysis (p=0.048). Stepwise regression analysis showed that the specific dimension of kidney disease with a coefficient of determination of R²=0.79 is able to significantly predict changes in quality of life as the most important variable. Conclusion: According to the results of the present study, the quality of life of hemodialysis patients is moderate and the most important factor in changes in the living standards of hemodialysis patients is related to the specific dimension of kidney disease. Also, with increasing income level and education level, the quality of life has increased, but with increasing the duration of dialysis, the quality of life has decreased.}, Keywords = {Hemodialysis, Quality of Life, Chronic Kidney Disease}, volume = {15}, Number = {2}, pages = {23-31}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/15.2.23}, url = {http://jccnursing.com/article-1-622-en.html}, eprint = {http://jccnursing.com/article-1-622-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2022} } @article{ author = {Ghahramani, Shahin and Mahmoudi, Mokhtar and Nouri, Bijan and Valiee, Si}, title = {Quality of Dying and Death Care from the Perspective of Nurses Working in Intensive Care Units}, abstract ={Background and Aim: Due to the high mortality of patients admitted to Intensive Care Units (ICUs), the provision of high‌ quality nursing care, especially for patients admitted to these wards, is of great importance. This is why the quality of death and dying in these wards is necessary. The aim of this study was to determine the quality of dying and death from the perspective of nurses working in ICUs. Methods:  The present study was performed cross-sectional in the teaching hospitals of Kurdistan University of Medical Sciences. The research samples in this cross-sectional study were 105 nurses working in ICUs who were selected by census. Data collection tools included demographic information and Quality of Dying and Death Questionnaire (QODD). Results: The results of the present study showed that the mean and standard deviation of the quality of dying and death variable were 37.15±13.47 and below the mean. Among the items related to the quality of death, the highest average was related to receiving appropriate sedation during the stay in the ICU (5.80±2.41) and being touched or hugged by loved ones (4.90±2.78) and the lowest average quality of care was related to having a spiritual ceremony before the patient's death (2.12±2.59 (and having one or more visits to a religious or spiritual counselor (2.24±2.66).  There was a statistically significant relationship between the quality of dying and death and the history of passing training courses related to dying and death (P=0.03). Conclusion: It is recommended to hold training courses related to quality of dying and death care criteria for personnel working in ICUs, as well as to evaluate the quality of mortality care from the perspective of the families of patients admitted to the ICU.}, Keywords = {Quality of Health Care, Nurse, Critical Care, Death}, volume = {15}, Number = {2}, pages = {32-39}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/15.2.32}, url = {http://jccnursing.com/article-1-613-en.html}, eprint = {http://jccnursing.com/article-1-613-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2022} } @article{ author = {Gashmardi, Noushi}, title = {Causes and Consequences of Hypoxia/Hypoxemia due to COVID-19: A Narrative Literature Review}, abstract ={Background and aim: COVID-19 is the third pandemic disease with respiratory manifestations after Severe Acute Respiratory Syndrome (SARS-Cov) and Middle East Respiratory Syndrome (MERS-Cov). One of the problems of patients with SARS-CoV2 infection is hypoxia and hypoxemia, which is considered to be seriously life-threatening. Given that there is no sufficient consensus to causes and consequences of hypoxia / hypoxemia, therefore this study was conducted to review the causes and consequences of hypoxia/hypoxemia due to COVID-19. Methods: This narrative review study was carried out through a library literature review in the databases including Science direct, Scopus, EMBASE ، Web of Science ، PubMed, SID, WHO, CDC, Springer, Elsevier and Google Scholar search engine in Persian and English during 2019 to 2022. Articles were evaluated and selected based on the inclusion and exit criteria. At first, duplicate articles in regards to their titles and then unrelated articles were deleted.  Finally, data analysis were done by a comprehensive review of articles and the removal of those that were not related to the objectives of the present study. Results: Out of 1275 searched articles, 42 were selected and analyzed. The results showed that lung injuries, activation of immune system and induction of inflammatory reactions, central nervous system injuries and underlying diseases are the causes of hypoxia and hypoxemia. Brain and nerve damages, gastrointestinal disorders, heart damages and liver damage can be caused by hypoxia and hypoxemia and delirium, encephalopathy, encephalitis, seizures and kidney damage caused by hypoxia. Conclusion: Although respiratory infection is more common in patients with COVID-19, some patients suffer from hypoxia or hypoxemia and the side effects associated with both. In order to cause oxygen homeostasis, early detection and therapeutic interventions are essential that during oxygen therapy, secondary injuries of this therapeutic intervention should be considered. Also, investigating the level of inflammatory and immune markers, may help in the early detection of them in patients.  }, Keywords = {Organs, Clinical Manifestations, SARS-COV-2 (COVID-19), Hypoxai, Hypoxemic}, volume = {15}, Number = {2}, pages = {40-59}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/15.2.40}, url = {http://jccnursing.com/article-1-625-en.html}, eprint = {http://jccnursing.com/article-1-625-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2022} } @article{ author = {Shakeri, Bahre and Vatandost, Salam and Nouri, Bijan and Valiee, Si}, title = {Effective Factors on the Administration of Chemical Restraint among Nurses in Intensive Care Units (ICUs): An Observational Study}, abstract ={Background and Aim: Chemical restraints are drugs used to restraint a patient's involuntary movements or emergency control of the patient's aggressive behavior and to cause sedation and pain relief, reduce symptoms, and reduce the likelihood of harming oneself or others. Improper use of chemical restraints can lead to complications in patients and can even delay the separation of patients under mechanical ventilation from the ventilator. The aim of this study was to investigate the effective factors in nurses' use of chemical restraints in patients admitted to intensive care units (ICUs). Methods: This research was an observational study. The statistical society of the research included 160 hospitalized patients in ICUs at Kowsar hospital, Sanandaj, Iran. After eight hours of hospitalization and stability of their conditions, those patients in ICUs were assessed based on administrating of chemical restraint by nurses. Independent risk factors for the administration of chemical restraint were investigated by using the logistic regression model. Results: Among the 160 patients admitted to ICUs, 105 patients (65/62%) underwent chemical restraints. The most common time to use chemical restraints was during the night shift and then the evening shift. Comparison of patients for whom chemical restraint was used or not, showed that the two groups in terms of smoking history (P=0/037), intubation (P=0/0001), dressing (P=0/001) and drain (P=0/001) as well as NGT (P=0/010), GCS (P=0/012), FOURscore (P=0/050), type of nursing shifts (P=0/017), restlessness (P =0/004) had a statistically significant difference. The relationship between BMI variables, alcohol addiction, drug addiction, having a catheter, fixator and traction, delirium, having a dressing, nurse to patient ratio, underlying disease and mechanical ventilation mode using Chemical restraints was not significant (P>0/05). The results of logistic regression analysis showed that between smoking (P=0/041, OR=3/232), being intubated (P=0/0001, OR=75/959), having a drain (P=0/016, OR=669), and FOUR score (P=0/0001, OR=0/944), there was a significant relationship using chemical restraints. Conclusion: Regarding the results of the present study, it could be concluded that the administration of chemical restraints is increasing among nurses in ICUs. Therefore, the necessity of the clinical guidelines and policies for the administration of chemical restraint are highlighted.}, Keywords = {Chemical restraint, Nurses, Intensive Care Unit}, volume = {15}, Number = {2}, pages = {60-68}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/15.2.60}, url = {http://jccnursing.com/article-1-624-en.html}, eprint = {http://jccnursing.com/article-1-624-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2022} } @article{ author = {RahatDahmardeh, Alireza and Khoshfetrat, Masoum and Keykha, Aliakbar}, title = {Comparison of the Ability of Marshall and Rotterdam CT Scan Scoring System in Determining the Prognosis of Traumatic Brain Injury Patients: A Cross-Sectional Study}, abstract ={Background & Aim: Predicting the final outcome of patients with traumatic brain injury is crucial for making the right clinical decision and determining the course of treatment. The aim of this study was to compare the ability of Marshall and Rotterdam scoring systems to determine the prognosis in patients with traumatic brain injury. Materials: The present research is a cross-sectional study. The statistical population of the study consisted of patients with traumatic brain injury admitted to the Intensive Care Unit (ICU) of Khatam al-Anbia Hospital in Zahedan from 2021 to 2022. In order to carry out this study, 287 patients were selected by convenience sampling method based on inclusion criteria. Patients were first evaluated by an intensive care physician to determine the prognosis with the APACH II Scale. The Marshall and Rotterdam scores of each patient were then determined by a radiologist based on a brain CT scan, and the patients were evaluated for the entire period of hospitalization until the final outcome (discharge or death) was determined. Finally, the data were compared to determine the ability of the two scales to predict outcomes. Results: Out of the 287 patients, 33 (11/5%) died and 254 (88/5%) survived. The mean score of the Marshall Scale in the deceased patients was 4.69±1.01 and was 2.03±1.3 in the survived patients. The mean score of the Rotterdam Scale in the deceased patients was 5/33±0/95 and was 2/14±0/89 in the survived patients. In both cases, this difference was statistically significant (P=0/001). The mean score of the APACH II scale was 24/04±8/2 in the deceased patients and 16/08±7/3 in the survived patients. The correlation between Rotterdam and Marshall Scales in determining the outcome of patients, with APACH II was positive and high. The agreement between the APACH II and Rotterdam scales was greater in predicting mortality. The results of regression model showed that gender with (OR=2/91), head injury due to accident with (OR=3/04), Marshall Score above 4 (OR=1/97), Rotterdam score above 4 (OR=2/84) and Apache II score above 15 (OR=1/97) have a significant relationship with patient mortality. Conclusion: According to the findings of the present study, it can be stated that both the Marshall and Rotterdam scales can determine the prognosis of patients with traumatic brain injury.}, Keywords = {Traumatic Brain Injury, Marshall Classification System, Rotterdam CT Grading System, APACH II}, volume = {15}, Number = {2}, pages = {69-81}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/15.2.69}, url = {http://jccnursing.com/article-1-627-en.html}, eprint = {http://jccnursing.com/article-1-627-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2022} } @article{ author = {Khodayari, Sajjad and Seylani, Khatereh and Sharifi, Farshad and Navab, Elham}, title = {The Effect of Manual Hyperinflation and Postural Drainage on Respiratory Indices in Patients under Mechanical Ventilation in Intensive Care Units}, abstract ={Background and Aim: Accumulation of secretions is one of the serious complications in patients under mechanical ventilation. The management of airway secretions in these patients includes using the usual methods like fluid therapy as well as techniques such as changing the patient's position and manual hyperinflation. Tracheal suction, which is performed with the aim of secretion removal, can be effective in improving airway clearance along with manual hyperinflation techniques and postural drainage. This randomized clinical trial was conducted in order to compare the effect of Manual Hyperinflation (MH) and Postural Drainage (PD) on the respiratory parameters of patients under mechanical ventilation. Methods: This crossover clinical trial study was conducted in the Intensive Care Units (ICUs) of Imam Khomeini Hospital, Ilam in 2018. The sample size included 50 patients under mechanical ventilation who were included in the study according to the inclusion criteria through convenience sampling. After the first 24 h, patients received routine respiratory care in the ICU. Each patient was randomly assigned to one of the two intervention groups, MH or PD for 24 h. Then, the patient was transferred to the next intervention group. Data collection tool included a demographic questionnaire and a form for recording respiratory variables (including dynamic compliance, arterial blood oxygen saturation percentage, tidal volume, Peak Inspiratory Pressure and Positive End Expiratory Pressure). On the first day, after selecting the patient and recording the demographic information, when the patient needed suction, the patient's respiratory variables were recorded at three times including before suction, 5 and 25 min after suction, and the results were recorded as the basic information (control). During the second day, in addition to receiving routine respiratory care, before each suction, depending on the intervention group, the patients were subjected to MH or PD and respiratory variables were recorded before suctioning as well as 5 and 25 min after suction. On the third day, the patient was assigned to the next intervention group (crossover design) and the evaluation of respiratory variables was repeated and the results were recorded. Results: Based on the repeated measure ANOVA, atrial blood oxygen saturation (P value=0.001), tidal volume (P value=0.001) and dynamic compliance (P value=0.038) in the intervention groups, 25 min after suction were more than the control group, in favor of MH intervention comparing to PD intervention. Regarding the peak inspiratory pressure, the intervention of MH 25 min after suction created a significant decrease compared to the PD (P value=0.001). There was no significant difference in the PEEP between any of the study phases and the investigated times.  Conclusion: The findings reconfirmed the necessity of nursing interventions in order to manage airway secretions, and also showed that MH intervention is more effective than PD in improving the respiratory indicators. Therefore, while emphasizing the necessity of training HCWs for respiratory care and management of airway clearance in patients under mechanical ventilation, it is suggested to prepare evidence-based clinical guidelines emphasizing the superiority of MH intervention in order to improve the respiratory indicators of patients.}, Keywords = {Manual Hyperinflation, Postural Drainage, Respiratory Indices, Mechanical Ventilation, Intensive Care units}, volume = {15}, Number = {2}, pages = {82-91}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/15.2.82}, url = {http://jccnursing.com/article-1-611-en.html}, eprint = {http://jccnursing.com/article-1-611-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2022} }