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Aims: Quality of Life (QOL) is a strong predictor of mortality for end stage renal disease patients. This has resulted in QOL becoming the most important measure by which to present the outcome of these patients. The aim of this study was to measure QOL in renal transplant patients in Tehran . Methods: This is a descriptive-analytic study which was performed on 220 renal transplant patients referred to transplantation and nephrology clinic of two Tehran city selected hospitals in year 2009. A demographic and a Kidney Transplant Questionnaire (KTQ-25) were used in order to collect data. The reliability of KTQ-25 was determined 0.93 by Cronbach Alpha method and the questionnaire was filled by patients. Data were analyzed by SPSS 16 and descriptive and analytic statistics. Results: The mean of QOL in this study was 4.9±1.27, the maximum score was obtained in appearance dimension and the minimum score was obtained in fear dimension. Relation between QOL score and gender (p<; 0.001), cause of End Stage Renal Disease (p=0.02), occupation (p=0.002) and economic satisfaction (p=0.02) was significant. Conclusion: Tehran city kidney transplant patients’ QOL level is moderate.

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Abstract Aims: H emodialysis Patients suffer from many problems and complications during disease and their treatment.One of the most important and common problems is hypotension and dialysis adequacy.This study has been designed and implemented to determine the effect of hypertonic glucose on dialysis adequacy and blood pressure in non-diabetic dialysis patients. Methods: The present study was a quasi-experimental and single group study that 45 none-diabetic hemodialysis patients from the chosen hospitals were selected and hypertonic glucose infused patients for two weeks and three times a week, after two weeks durability, patients were assessed without manipulation for two weeks. In addition blood pressureand dialysis adequacy of the patients were measured in manipulation phase before and after each infusion of hypertonic glucose .Data collection tools included demographic information and dialysis adequacy was calculated by Daugirdasformula at the end of every stage in two study environments.then the data were analyzed by using SPSS 17 software and descriptive statistical tests (abundance- mean),inferential tests (paired t test, mane Whitney, Friedman, Kruskal-wallis and wilcoxon) Results: The results showed thatdialysis adequacyand also blood pressure of the patients had been increased significantly in manipulation phase ( p=0.001 ). Andanalysis of data between the gender (p=0.001) and vascular access ( p=0.001 ) showed significant differences ( p=0.001 ),but inother cases , there was no significant difference. Conclusion:results of this study showed thatinjection of hypertonic glucose increased dialysis adequacy in hemodialysis patients significantly and prevented hypotension.

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Aims: Due to increasing the number of Hemodialysis patients and also the necessity of consistent and continuous cares by family members to patients, we have been up to doing a test in order to find out the effects of oral Vitamin C on tiredness and exhaustion of hemodialysis patient caregivers according to researches that have been done on the effect of oral Vitamin C on fatigue. Methods: This research is a before-after one-group semi experimental study of a that has been done in 2012. The samples were 25 caregivers who have been coming to the selected hospital in Tehran and they had been chosen randomly and purposively. At first The Multidimensional Fatigue Inventory MFI-20 Questionnaire was completed by research samples before intervention and after a month of using oral Vitamin C the Questionnaire was completed once again. After collecting the data by descriptive statistics and paired t-test the data had been analyzed by SPSS 17 software. Results: The samples were 48% male with the age average of 44.4 and 72% married. In general exhaustion and fatigue, physical fatigue, mental fatigue and reduced activity dimensions significant difference (p<; 0.05) had been observed but there was no significant difference in the reduced motivation dimension. Conclusions: According to the results, using oral Vitamin C can be recommended for reducing the fatigue of caregivers and thereupon increasing the quality of care given to Hemodialysis patients.

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Aims : Fatigue is one of the most common dialysis side effects and it has been among the main nursing diagnosis in hemodialysis patients and it can predict cardiovascular events and its mortality in hemodialysis patients as a bioalarm. Considering that decrease in Serum level of vitamin C is one of the main causes of fatigue in these patients, this study had been done with the aim of evaluating the effect of supplementation with intravenous vitamin C on fatigue in hemodialysis patients . Methods : In a randomized, parallel group, double-blind clinical trial , 177 patients with chronic renal failure who referred to hemodialysis units of Baqiatallah and Chamran hospital in Tehran were studied. They distributed in three groups of experimental, control and placebo in 2011. In addition to demographic questionnaire , multidimensional questionnaire (MFI) had also been used for determining fatigue before and after intervention. Then in experimental group an 2.5cc injection contacting 250 mg vitamin C was injected three times every week, at the end of each dialysis session via the intravenous route , for 8 weeks. In the placebo group normal saline placebo had been injected with the same amount for the same time and there was no intervention in the control group. In order to analyze data statistically and compare them between groups, SPSS statistical software , and Chi square, T-test, Paired t-test and ANOVA were used . Results: Complain of fatigue was observed in 81/6 % of patients and 30/7% of these patients suffered from severe fatigue before the intervention . The average loss of activity, physical fatigue and general fatigue had respectively higher mean in compare with the other five of fatigue dimensions .The mean of total scores of fatigue five dimensions was 65.39±15.92. After the end of intervention there was significant difference between findings of the three groups fatigue mean was decreased in experimental group to ( 52.28±13.82). Conclusion: Vitamin C supplementation can decrease fatigue significantly and it can be used as a simple, safe and inexpensive way .

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Aims : Anemia is one of the main problems in hemodialysis patients, which is caused by inadequate production of erythropoietin. Functional iron deficiency (FID) anemia is a kind of anemia, which lack of functional iron therein leads to resistance and inappropriate response to erythropoietin in hemodialysis patients. Since early diagnosis of this anemia before erythropoietin usage is important, this study was conducted “to determine p revalence of functional iron deficiency in hemodialysis patients”. Methods: In a cross–sectional design studied 184 patients with chronic kidney disease referred to hemodialysis units in Baqiyatallah and Chamran hospitals in Tehran. In order to data collecting were measured serum Hb, Hct and Ferritin levels plus to completing the demographic questionnaire. The χ2-test, T-test and ANOVA were used in this study. The data were analyzed via the SPSS18 software (version). The p value of 0.05 was considered as significance level. Results: The mean of serum levels of Hb and Hct was respectively 10.98±1.7 g/dl and 34.1±5.2%. Anemia was observed in 37%, hyperferritinemia in 80.4% and functional iron deficiency anemia in 41.1% of patients. Conclusions: Functional iron deficiency was observed in about half of hemodialysis patients and could cause resistance and inappropriate response to Erythropoetin in them. Therefore nurse awareness and his/her duly action in determining the status of iron stores prior to the administration of erythropoietin prevents from prescribing an expensive drug and imposing unnecessary costs to the patient and the health care system.

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Aim s: Adherence to dietary regimens is essential to the success of hemodialysis whose absence is associated with significant health problems and complications for patients receiving hemodialysis. Besides educations, hemodialysis patients need a continuous care plan that improves their adherence knowledge, practice, and attitude. This study aimed at examining the effect of Continuous Care Model on hemodialysis patients’ dietary adherence. Methods : This randomized controlled trial was conducted on 98 patients who received hemodialysis in Baqiyatallah and Chamran hospitals, Tehran, Iran, in 2013. Subjects were recruited by using the purposive sampling technique and were randomly allocated to either the treatment or the control groups. Written and verbal educational materials about hemodialysis and dietary adherence were provided to patients in the treatment group. Then, the four-step continuous care plan was implemented. The steps included orientation, sensitization, control, and evaluation. Study participants were invited to fill the Dietary Adherence Questionnaire at four time points including before the intervention (T1) as well as one, two, and three months afterward (T2–T4). The Chi-square and the repeated measures analysis of variance test were performed by using the SPSS v. 18.0. Results : Most participants had poor dietary adherence. The Continuous Care Model significantly improved their dietary adherence scores—from 148.95±6.04 (T1) to 156.25±4.85 (T2), 177.08±3.63 (T3), and 184.37±3.38 (T4). There was a significant relationship between Continuous Care Model and dietary adherence (P value = 0.0001). Conclusion s: Educations and counseling services that are provided through the Continuous Care Model can improve hemodialysis patients’ dietary adherence. Using this model for enhancing hemodialysis patients’ dietary adherence and preventing non-adherence-related complications is recommended.

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Background and aim: any change in health situation will affect the role of the nurse. Since the adherence to treatment in hemodialysis patients plays a significant role  and Failure to comply with it may have dangerous side effects and even death, so nurse as one of the pillars of treatment can reduce such Complications with his/her educational role in hemodialysis patients. This study aimed to assess the effect of utilization of Continuous care model on adherence to treatment.
Methods: This study is a clinical trial with a purposive ambling technique, After selection according to inclusion criteria, 98 hemodialysis patients from baqiatolah and chamran hospital were Randomly divided into two experimental and control group, three months of continuous care intervention on the experimental group was conducted And by the end of each month adherence to treatment status of patients in both groups was evaluated and compared with the Kim exclusive questionnaire of adherence to treatment.
Result: adherence to treatment trend of changein the intervention group was increase inguinal three stages of evaluation which this difference was statistically significant (P=0/0001).
Conclusions: Due to the significant increase in adherence to treatment after applying continuous care model, teaching the self-care skills to this group of patients and also other chronic diseases is recommended.

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Introduction: One of the most important problems in the intensive care unit patients is the increase  sensory over load. Delirium and agitation are its consequences. The aim of this study was to evaluate  the effect of using non-invasive methods such as the use of eye masks and earplugs on the level of agitation  and the prevalence of delirium in hospitalized patients in intensive care units.
 
Materials and Methods: Present study was a randomized clinical trial of two groups of 88 patients admitted to the intensive care unit of Besat Educational and Medical Center in Hamadan in 2017. Patients were randomly divided into two groups:  intervention and control. The intervention lasted from the second night for seven nights. In the intervention group for patients from 10 pm to 6 am simultaneously, eye mask and earplug were used and in the control group, no special intervention was performed. To measure the incidence of delirium, the CAM-ICU questionnaire and the RASS questionnaire were used to assess the level of agitation.
 
Results: The results of this study showed that patients in both intervention and control groups did not differ in terms of demographic characteristics, room conditions and hospitalization reasons. The results also showed that the use of instruments such as earplug  and eye plug  significantly reduced the level of agitation  (based on the RASS scale) in the intervention group compared to the control group (P = 0.001). Also, the incidence of delirium based on CAM-ICU scale in the intervention group had a significant reduction rather than control group (P <0.001).
 
Conclusion: The use of eye mask and ear plug can reduce the incidence of delirium agitation of hospitalized patients in the intensive care unit
 

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Background & aim: Hemodialysis significantly alters the daily life and health of patients with kidney failure, impacting their quality of life and sleep. This study aimed to assess the impact of an easy exercise regimen on hemodialysis outcomes.
Methods: This cross-sectional interventional study utilized a pre-post design involving 42 hemodialysis patients selected via census. Demographic data were recorded, and baseline assessments of quality of life and sleep quality were conducted using the Kidney Patients Quality of Life Questionnaire (KDQOL-SFTM) and the Richard Campbell Sleep Quality Questionnaire, respectively. Additional measures included KT/V and biochemical tests. Participants engaged in the Easy Workout program three times per week during dialysis sessions over a 12-week period, after which post-intervention assessments were conducted.
Results: After the interventions, the sleep quality of the patients increased significantly (P<0.001). The adequacy of dialysis compared to before the intervention showed a statistically significant increase (P = 0.039). The general dimension and the specific dimension of the quality of life of the patients increased significantly after the interventions (P<0.001).
Conclusion: Easy exercises during hemodialysis improve sleep quality, quality of life and dialysis adequacy of hemodialysis patients. It is suggested to use easy exercises to improve the health status of patients during hemodialysis.