Showing papers in "Holistic Nursing Practice in 2020"

The Effect of Laughter Therapy on Anxiety: A Meta-analysis.

Abstract: This meta-analysis was conducted to determine the effect of laughter therapy on anxiety. Randomized controlled clinical trials were reviewed on Google Scholar, PubMed, and ISI Web of Sciences databases. Four randomized controlled trials consisting of 157 participants were included in the meta-analysis. Hedge's g test statistics were used to show the common effect between the laughter therapy and control groups in the meta-analysis. Laughter therapy can decrease anxiety levels (standardized mean difference = -1.144; 95% CI, -1.950 to -0.338). Laughter therapy is an effective complementary method to decrease anxiety.

The Effect of Aromatherapy on Sleep Quality and Fatigue Level of the Elderly: A Randomized Controlled Study.

Abstract: This randomized controlled experimental study was conducted to determine the effect of inhaled aromatherapy on the sleep quality and fatigue level of the institutionalized elderly. The sample of the study consisted of a total of 59 elderly individuals (30 in the intervention group and 29 in the control group) who met the inclusion criteria and agreed to participate in the study. Aromatherapy (lavender oil) inhalation was administered to individuals in the intervention group half hour before their sleep every day for a month in accordance with aromatherapy protocol. No administration was applied to the control group. The data were collected using the Elderly Description Form, Pittsburgh Sleep Quality Index, and Fatigue Severity Scale. Forms were completed in the beginning of administration and in the follow-up at the end of 4 weeks (baseline and last follow-up). In the study, it was determined that aromatherapy administration improved sleep quality (P < .001) and decreased fatigue severity in the elderly (P < .05). The study should be replicated in a different group.

The Effect of Aromatherapy Application on Cognitive Functions and Daytime Sleepiness in Older Adults Living in a Nursing Home

Abstract: Changes in the aging process affect the duration and quality of sleep. Not having a quality night's sleep leads to a reduction in daytime wakefulness in older adults. We examined the effect of aromatherapy on the cognitive functions and daytime sleepiness of older adults living in a nursing home. The research was a pretest and posttest design, which was conducted without a control group. The sample included 39 elders. A rosemary-lemon oil mixture was smelled by elders in the mornings for a week. After a 1-week washout period, lavender oils were smelled in the evenings for a week. After application of the rosemary-lemon oil mixture, the mean score of participants' daytime sleepiness was lower, but that decline was not statistically meaningful (P > .050). After the same application, the mean score of the participants' cognitive functions was significantly lower (P < .001). After application of lavender oil, the scores were significantly lower (P < .001). Lower scores on the scales used indicate lower sleepiness. The results showed that the 2 applications can be used to improve cognitive functions in older adults; in addition, lavender oil has an advantage in reducing daytime sleepiness.

The Effect of Progressive Relaxation Exercises on Pain, Fatigue, and Quality of Life in Dialysis Patients.

Abstract: Patients receiving hemodialysis treatment may experience several symptoms at the same time, such as fatigue and pain. Progressive relaxation exercises (PRE) have been reported to have positive effect on the control of these symptoms. In this study, a randomized, controlled, and experimental study was conducted to examine the effect of PRE on pain, fatigue, and quality of life in hemodialysis patients; the study was carried out with 48 intervention and 48 control patients receiving treatment in the hemodialysis units of 2 hospitals. Data were collected by a questionnaire prepared by the researcher, which included questions about sociodemographic variables and the disease; Piper Fatigue Scale; Visual Analog Scale that measures pain severity; and SF-36 Quality of Life Scale. The results of study revealed that mean total fatigue score and mean pain score decreased in the intervention group after the application of PRE; whereas no change was observed in the control group (P < .05). It was also found that quality of life physical component mean score and mental component mean score increased in the intervention group after the application of PRE (P < .05).

A Narrative Review of Movement-Based Mind-Body Interventions: Effects of Yoga, Tai Chi, and Qigong for Back Pain Patients.

Abstract: This narrative literature review evaluated the effects of movement-based mind-body interventions (MMBIs; yoga, tai chi, and qigong) on low back pain. A search of databases was conducted to identify relevant studies. Thirty-two articles met inclusion criteria and were included for this narrative review. Of the reviewed studies, the highest number focused on yoga intervention (n = 25), 4 focused on qigong, and 3 focused on tai chi in managing back pain. The selected articles showed MMBI to be effective for treatment of low back pain, reporting positive outcomes such as reduction in pain or psychological distress (eg, depression and anxiety), and improved functional ability. However, little is known about the effects of MMBI, in particular qigong and tai chi. More clinical trials are needed to determine how to reduce back pain, improve physical function, and minimize behavioral and psychological symptoms associated with low back pain. Nurse practitioners may introduce such mind-body interventions for managing pain, especially for patients at high risk for adverse effects from pharmacological treatment, and refer them to a yoga therapist, tai-chi instructor, or qigong instructor.

An Exploratory Study of a 3-Minute Mindfulness Intervention on Compassion Fatigue in Nurses.

Abstract: This study shows that breathing mindfully for 3 minutes over a period of 4 weeks, positively affects compassion fatigue in nurses. A nonrandomized, pre/postintervention study was conducted using a 3-minute attentional breathing intervention. Thirty-two nurses participated over 4 weeks. The intervention demonstrated statistically significant reductions in compassion fatigue measures.

A Pilot Study on Sleep Quality, Forgiveness, Religion, Spirituality, and General Health of Women Living in a Homeless Mission.

Abstract: This cross-sectional pilot study evaluated associations between religion/spirituality, forgiveness, sleep, and health, which were all highly correlated for adult women living in a homeless mission. While causation cannot be determined, these findings help to provide a theoretical framework for studies with stronger designs, prospective measurements, and larger sample sizes.

The Effect of Foot Massage on Peripheral Neuropathy-Related Pain and Sleep Quality in Patients With Non-Hodgkin's Lymphoma.

Abstract: This study, which was conducted on patients with non-Hodgkin's lymphoma, aimed to evaluate the effect of foot massage on peripheral neuropathic pain and sleep quality. The survey was conducted between November 2018 and April 2019. Research data were collected through questionnaire, visual analogue scale (VAS), Douleur Neuropathique 4/Neuropathic Pain 4 (DN4) Questions, and Pittsburgh Sleep Quality Index. Classical foot massage was applied to participants in the intervention group, and they received 3 sessions a week, with each session lasting for 20 minutes over a period 4 weeks. After each massage session, pain levels were again assessed using the VAS and DN4 questionnaires. It has been shown that foot massage intervention reduces the patients' pain levels and has a positive effect on their sleep quality. Accordingly, foot massage can be recommended to patients with non-Hodgkin's lymphoma to reduce their peripheral neuropathy-related pain and improve their sleep quality.

Making Do During a Pandemic: Morally Distressing and Injurious Events.

Abstract: The coronavirus disease (COVID-19) pandemic has placed nurses and other health care professionals in morally distressing situations related to personal safety, resource allocation, and family versus public care needs Making do, referring to managing with insufficient means, has been the norm of pandemic testing and care Health care professionals and essential employees at the sharp point of care and service have been required to pay the price associated with this new normal Some have described these crushingly difficult circumstances as contributing to moral injury and moral distress Nurses, physicians, and other essential professionals are affirmatively responding to demands for their services while acknowledging that necessary clinical equipment and protective gear are unavailable in the quantities required for safe care delivery Moral injury is unique from moral distress Moral injury has its roots in war and was diagnosed in veterans harmed after perpetrating, failing to thwart, or witnessing acts that violated their deeply held moral convictions and expectations

Effects of the Continuous Care Model on the Health-Promoting Lifestyle in Breast Cancer Survivors: A Randomized Clinical Trial.

Abstract: Breast cancer is the most frequently diagnosed cancer and the chief cause of cancer-related death among women worldwide, with the incidence increasing exponentially particularly in low- to middle-income countries. The increase in the incidence of breast cancer is partly accounted for by increases in life expectancy due to improvements in public health, but also related to an increase in risk factors for cancer including smoking, excess body weight, decreased physical activity, and changes in reproductive activity. Health-promoting lifestyle is therefore one of the major topics of importance in studying chronic illnesses and cancer. Health promotion interventions, including the use of care models, have a vast contribution to make in terms of timely diagnosis and improved survival. One such care model, which has been designed to increase self-care, adherence, and performance in chronic patients, is the continuous care model (CCM). This study was conducted with the purpose of determining the influence of the CCM on the health-promoting lifestyle of patients with breast cancer during 2017-2018. In this randomized clinical trial, 60 patients with breast cancer were chosen by convenience sampling followed by random allocation into treatment and control groups. Six sessions of group discussion were held for the treatment group according to the CCM and items in the health-promoting lifestyle questionnaire. Data collection tools included a general health questionnaire, a demographic questionnaire, a family support questionnaire, and the Health Promoting Lifestyle Profile (HPLP), which respondents completed before and after the intervention. P values ≤ .05 were considered significant. When comparing the mean score of health-promoting lifestyle in both the control and treatment groups, before and after the intervention, significant increases in every dimension were observed. The average overall health promotion lifestyle was revealed to be significantly elevated from 123.48 to 147.12. However, in the control group the mean scores had slightly increased or were the same in all the dimensions. In addition, the average overall health promotion lifestyle had increased from 119.89 to 121.32. The observed difference in mean scores was not statistically significant. The CCM increased the score of health-promoting lifestyle of patients with breast cancer. Therefore, this caring model can be considered an alternative to improve healthy lifestyles of patients with cancer.

Effect of Inhalation Aromatherapy on Pain, Anxiety, Comfort, and Cortisol Levels During Trigger Point Injection.

Abstract: The objective of this study was to examine the effects of inhaler aromatherapy on the level of pain, comfort, anxiety, and cortisol during trigger point injection in individuals with myofascial pain syndrome. Lavender oil inhalation was found to reduce pain and anxiety during trigger point injection and to improve patient comfort, but it did not affect the saliva cortisol level.

A Metaphor Analysis of Patients' With Chronic Conditions Experiences With Holistic Nurse Coaching.

Abstract: The purpose of this study was to examine metaphors used by patients with chronic conditions to describe their experience with holistic nurse coaching. A secondary analysis was conducted using Metaphor Identification Procedure to analyze the corpus of 112 pages of typed transcription. Five metaphors emerged: (1) taking personal power back like acquiring a new toolbox; (2) seeing health challenges from different angles like a duck pond race; (3) shifting perception of a chronic condition like a spider turned into a friend; (4) engaging in self-care like caring for a favorite plant; and (5) choosing to focus on the positive like a collage that changed from dark to light. Specific interventions can be developed to address each of these metaphors to help patients live well with chronic conditions.

The Effect of Reflexology on Low Back Pain in Operating Room Nurses.

Abstract: Operating room nurses often face acute or chronic back and low back pains, shoulder and neck injuries. In recent years, the use of complementary and alternative treatment methods has been increasing due to the fact that pharmacological treatment cannot control the pain in general, and its various side effects and cost. The aim of this study was to investigate the effect of foot reflexology on low back pain of operating room nurses. This quasiexperimental study was conducted with 38 operating room nurses. The nurses in the experimental group were given a 30-minute reflexology protocol once a week for 4 weeks and their pain levels were assessed again at week 5. The control group nurses did not receive any intervention. Data were collected using a demographic information form and a visual analog scale (VAS). The low back pain of the nurses in the reflexology group decreased significantly at week 5 compared with week 1, whereas the severity of low back pain of the nurses in the control group did not change between weeks 1 and 5. There were no statistically significant differences between the groups in terms of the mean VAS pain score at week 1. However, the nurses in the reflexology group had significantly lower VAS pain mean scores at week 5 than the control group. In this study, reflexology significantly reduced the pain of nurses who had low back pain. Therefore, reflexology might be useful in controlling low back pain of operating room nurses.

The Effect of Self-Care Program Based on Modeling and Role Modeling Theory on Body Image Nurturance in Patients With Colorectal Cancer: A Randomized Clinical Trial.

Abstract: One of the most critical disorders among patients with colorectal cancer is a change in their body image. This study aimed to examine the effect of a self-care program based on the modeling and role-modeling theory on nurturing body image of patients with colorectal cancer. In 2018, a 2-group randomized clinical trial was conducted in Mashhad, Iran. According to the modeling and role-modeling theory, 27 patients allocated in the experimental group received five 30- to 45-minute sessions at the hospital and 4 sessions of phone counseling within 2 weeks. Twenty-seven patients randomly allocated in the control group received the routine care. Data were collected by demographic and body image scales 3 times with the patients. The mean age of the patients in experimental and control groups was not significantly different (P = .46). The mean scores of the body image at the admission time were 26.8 ± 2.6 in the experimental and 27.9 ± 3.1 in control groups (P = .12). However, the mean scores of body image of the experimental group were 24.3 ± 4.6 at the discharge time and 28.1 ± 2.1 during the follow-up phase. In the control group, the body image scores were 21.0 ± 5.6 at discharge time and 22.9 ± 6.1 during the follow-up phase. Repeated-measures analysis of variance revealed significant differences between the 2 groups (P ≤ .001). Application of the self-care program based on the modeling and role-modeling theory can play a critical role in nurturing the body image of patients with colorectal cancer.

Nontraditional and Home-Based Self-management Interventions in Cancer Patients With Pain: A Mixed-Method Systematic Review.

Abstract: One or 2 decades ago, oncologists focused on only cancer treatments or acute care related to cancer. Since cancer care is considered as long-term cares, cancer patients require self-management (SM) ability or skill to manage their symptoms and daily cares. This mixed-method review is to evaluate quantitative and qualitative studies, which were conducted using non-traditional SM interventions for cancer pain based. This review also explores the process of SM in the chronic care model (CCM). PubMed, CINAHL, Scopus, and Wiley were used from 2011 to 2018. A total of 16 quantitative and 2 qualitative studies were included for this review. All interventions are divided into 3 types, which are educational and/or counseling programs, complementary and alternative medicine (CAM) therapy, and exercise. Ten of the included 16 studies were statistically significant on pain management: 3 CAM studies (100%), 1 exercise study (100%), and 6 of the 12 educational and/or counseling studies (50%). The CAM and exercise were statistically effective in improving cancer pain in the review. However, uncertainty remains regarding the strength of the evidence, due to the small number of studies included and lack of consistent methodologies. The application (5A) of SM support may help cancer patients to manage their pain.

Effects of Acupressure on Preoperative Acute Anxiety in Cesarean Section Under Spinal Anesthesia: A Double-Blind Randomized Controlled Study.

Abstract: Anxiety during the preoperative period is a common problem experienced by women who will deliver by cesarean section. The use of nonpharmacological methods to control anxiety in pregnant women has been shown to be more appropriate. This double-blind randomized controlled experimental study was conducted to assess the effect of acupressure on acute anxiety developing before cesarean section under spinal anesthesia. In the present study, 82 pregnant women scheduled for surgery were randomly assigned to the acupressure and control groups including 40 and 42 persons, respectively. Acupressure was applied to HE-7 acupuncture points in the participants in the acupressure (intervention) group for 10 minutes before the surgery. The participants in the control group were subjected to the hospital protocol. Anxiety levels of the participating women were assessed twice preoperatively using the State-Trait Anxiety Inventory. Anxiety scores of the participants in the acupressure group before the procedure (49.13 ± 6.22) were higher than were those of the participants in the control group (41.71 ± 3.26); however, after the procedure, the anxiety scores decreased statistically significantly in the acupressure group (38.30 ± 4.45) compared with the control group (52.48 ± 7.30) (P < .001). Acupressure reduced the preoperative acute anxiety suffered by the participating pregnant women.

Nightingale's Legacy: Old Holistic Insight Supported by New Science.

Abstract: Nursing today could benefit from building on Florence Nightingale's legacy. The aim of this article is to describe and discuss how her holistic approach to nursing is supported by scientific discoveries within human ecology, psychoneuroimmunology, and communicology. This combination may bridge the gap between current nursing practices and Nightingale's ethos.

Slow Nursing and Its Holistic Place in Dementia Care: A Secondary Analysis of Qualitative Data From Nurses Working in Nursing Homes.

Abstract: Despite a growing body of research literature within dementia care, research concerning how to provide holistic quality care and its benefit for people with dementia is still scarce. In this study, a secondary analysis of original qualitative data from a former study was employed. Findings demonstrated that slow nursing embodies a holistic caring approach, which may improve the care quality provided to people with dementia. The current findings also provide key knowledge that may contribute to nursing research and education.

The Effect of Auricular Acupressure on Sleep Disturbance Among Patients With Leukemia: A Feasibility Study.

Abstract: Auricular acupressure (AA) is widely used in East Asia and Europe to manage patients with sleep disturbance. This feasibility study was performed to demonstrate the potential of AA for sleep disturbance in patients with leukemia. Thirty-two patients with leukemia with poor sleep quality received AA 3 times a day for a total of 4 weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality at baseline, at a 2-week intervention, and after a 4-week intervention. Compared with baseline scores, PSQI scores and the use of sleep medicine were significantly improved at week 2 and week 4 (P < .05). As a potential safety therapy, AA could be an alternative or complementary intervention to improve sleep quality for patients with leukemia with sleep disturbance.

The Effect of Auricular Acupressure and Positive Group Psychotherapy With Motivational Interviewing for Smoking Cessation in Korean Adults.

Abstract: The aim of this study was to investigate the effects of positive group psychotherapy with auricular acupressure on tobacco withdrawal symptoms and smoking cessation. This study used a randomized controlled trial design. Participants were randomly assigned to 1 of 3 groups: group 1 (counseling and auricular acupressure), group 2 (counseling and placebo acupressure), and the control group (self-help for smoking cessation). Positive group psychotherapy and auricular acupressure were performed once a week for 6 weeks. The smoking cessation rates for 1 year in groups 1 and 2 were higher than that in the control group (9.5%, 15.6%, and 0%, respectively; odd ratio: 7.98, P = .019, n = 109). There was a significant difference of tobacco withdrawal symptoms among the 3 groups over 4 weeks (F = 2.9, P = .04). The mean differences between week 1 and week 4 among the 3 groups were statistically significant (4.7 ± 6.96, 5.18 ± 7.9, and 0.14 ± 7.15, F = 4.25, P = .018).

End-of-Life Care Provided for Cancer Patients: A Metasynthesis Study.

Abstract: In the health care setting, and especially in cancer patients nearing the end of life, administrators, medical staff, patients, and families face challenges of a social, legal, religious, and cultural nature in the process of care. The present study aimed to perform a metasynthesis of qualitative studies conducted on providing end-of-life care for cancer patients. The present metasynthesis was conducted using Sandelowski and Barroso's method. A literature search was performed in PubMed, Scopus, Web of Science, and Embase databases, from the inception to date, and a total of 21 articles were identified as eligible for inclusion in the study. Critical Appraisal Skills Programme (CASP) criteria were used for assessing the articles, and data were analyzed by the subject review. Six themes were extracted for end-of-life care including psychological support, palliative support, educational-counseling support, spiritual support, preferential support, and supportive interactions, each comprising a number of categories. The most frequently mentioned categories were high-value care (67%) and adaptive acceptance (57%). The findings of this metasynthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The present study showed that providing high-value care and facilitating adaptive acceptance are important constituents of a holistic strategy for providing end-of-life care to cancer patients.

Checking the Pulse of Holistic and Culturally Competent Nursing Practice in Pennsylvania.

Abstract: Traditionally, underrepresented racial and ethnic groups experience marginalization, leading to inequities and disparities in health and health care. A holistic approach to care delivery can help providers meet a culturally diverse patient population's unique healing needs. A systematic assessment of nurses' cultural competency practice was conducted in Pennsylvania to reveal opportunities and provide direction for holistic, culturally competent health care services. This exploratory cross-sectional descriptive study used the Cultural Competence Education and Awareness Survey (CCEAS) to examine cultural competence practices of registered nurses employed in the state of Pennsylvania. A total of 1246 registered nurses completed the survey. Respondents expressed a strong desire for cultural competency. Education and organizational infrastructure to facilitate cultural competency could be improved. Health care leaders and policy makers at all levels should explore opportunities to strengthen nurses' culturally competent practices through ongoing professional-development activities and enhanced organizational infrastructure.

Empowering Nurses to Provide Humanized Care in Canadian Hospital Care Units: A Qualitative Study.

Abstract: Previous studies have reported a conflict between nurses' motivation to provide humanized care and practical requirements impeding them from doing so. This exploratory descriptive qualitative study aimed to explore nurses' perspectives on humanized care, the challenges they face, and, most importantly, their recommendations to overcome these barriers. Semistructured individual interviews were conducted with 17 auxiliary and registered nurses working in various health care units in a Canadian hospital. Participants demonstrated a good understanding of what humanized care covers and entails. They also described it as the very core of their profession and main source of job satisfaction. However, nurses reported that they are confronted with organizational barriers, mainly a lack of staff, the burden of administrative tasks, unsuitable physical environments or equipment, and little managerial support. Nurses stressed the need for a cultural change in managerial practices in order to be able to improve their provision of humanized care. Based on the findings, 4 structuring recommendations were identified: adopting an institutional policy promoting the implementation of humanized care, incorporating humanized care in nurses' tasks and procedures, improving participatory management, and ensuring adequate staffing.

Effectiveness of Music to Improve Anxiety in Hemodialysis Patients: A Systematic Review and Meta-analysis.

Abstract: Anxiety affects many hemodialysis patients. The response to treatment varies and often requires patients to take therapeutics for long periods; thus, many patients look for complementary approaches. There have been reports of music alleviating anxiety in hemodialysis patients. However, the efficacy of music needs to be evaluated. The objective of this study was to conduct a systematic review and meta-analysis to compare the effects of participation in standard care combined with music with standard care alone. This was a systematic review and meta-analysis of randomized controlled trials to determine the efficacy of music to lower anxiety in hemodialysis patients. Five studies were included in the review (290 patients). Listening to music resulted, on average, in an anxiety reduction that was -0.52 standard deviation units greater (95% confidence interval, -1.02 to -0.03 lower, P = .003) than in the standard care group. No adverse events were identified. All trials contained a risk of bias due to lack of blinding. The heterogeneity showed an I = 75%. The strength of evidence was very low. No adverse events were identified. Few trials were available for inclusion, with small sample sizes and significant heterogeneity. Within these considerable limitations there was a demonstrated decrease in anxiety for hemodialysis patients receiving standard care augmented with music. The effect size was moderate. Results were inconsistent across studies. We are uncertain about the estimate. The likelihood that effect will be substantially different is very high. Further research has a large potential for reducing uncertainty about the effects of the music interventions.

The Effect of an Empowerment Program on the Perceived Risk and Physical Health of Patients With Coronary Artery Disease.

Abstract: This study was conducted to assess the effect of an empowerment program on the perceived risk and physical health of patients with coronary artery disease. This randomized clinical trial recruited 84 patients with coronary artery disease admitted to post-cardiac care unit (CCU) wards in Tehran Heart Center in 2017. The study subjects were selected and assessed according to inclusion criteria and assigned to intervention and control groups by block randomization. Both groups completed questionnaires for demographic details and disease history, perceived risk in cardiac patients, and physical health. The Magic Empowerment Program was performed for the intervention group as 3 workshops on 3 successive days. Intervention continued after patients' discharge from the hospital through phone calls once a week for 8 weeks. The perceived risk in cardiac patients and physical health questionnaires were completed for both groups. Postintervention results showed significant differences between the 2 groups in total score of perceived risk (P = .001) and its subscales. The Empowerment Program changed patients' attitudes toward risk-motivating behavior change and improving physical health.

Nonmedical Interventions for Schizophrenia: A Review of Diet, Exercise, and Social Roles.

Abstract: Schizophrenia is a major mental illness with a disease course that is influenced by lifestyle. The risk-benefit ratio for alternative interventions is more favorable than for antipsychotics in long-term treatment. Dietary interventions may target autoimmune features, vitamin or mineral deficiencies, abnormal lipid metabolism, gluten sensitivity, or others. Examples of interventions involving diet, physical activity, or physical processes or social interventions including talk therapy exist in the literature. Notwithstanding, the general utility of these types of interventions remains inconclusive, awaiting long-term randomized trials. A perspective that separates the cause of the disease from its symptoms may be helpful in treatment planning and is warranted to distinguish between short-term and long-term recovery goals.

Effect of Guided Imagery Along With Breathing Relaxation on Sleep Quality of the Elderly Patients Under Abdominal Surgery: A Randomized Clinical Trial.

Abstract: Elderly patients undergoing surgery often suffer from sleep disorder. Holistic therapies might help them sleep better. The aim of this research was to determine the effect of guided imagery along with breathing relaxation on sleep quality in elderly patients undergoing abdominal surgery. A double-blind randomized clinical trial was conducted on 90 elderly patients undergoing abdominal surgery in 2 educational hospitals in 2018, Mashhad, Iran. The elderly patients with different abdominal surgical procedures were distributed to the wardrooms and then the rooms were randomly assigned into 2 groups. In the intervention group, the patients learned breathing relaxation the day before surgery and then an audiotape was provided to perform the guided imagery from the day before surgery for 5 days (twice) along with breathing relaxation. St Mary's Hospital Sleep Inventory was completed the night before, 48 hours and 96 hours after the surgery. Data analysis was done using SPSS 21 through analytical tests. Results of the test indicated that the score of sleep quality was significantly higher in the intervention group the night before surgery (P = .001). The total scores of sleep quality in the intervention group 48 and 96 hours after the surgery were significantly higher (P < .001). Based on results of generalized estimating equation model, the score of sleep quality for patients was 8.76 units higher in the intervention group than in the control group by controlling for the effects of time. Guided imagery along with breathing relaxation improved the sleep quality of the elderly patients undergoing abdominal surgery.Trial registration: IRCT20180731040652N1.

Effect of Massage With Lavender Oil on Postoperative Pain Level of Patients Who Underwent Gynecologic Surgery: A Randomized, Placebo-Controlled Study.

Abstract: This was a randomized, placebo-controlled study. The sample consisted of 3 groups of patients: an experimental group, massage application with lavender oil (n = 15); a placebo group, massage application with ultrasound gel (n = 15); and a control group (n = 15). Massage application was performed 3 hours after analgesic application. Pain levels of the patients in the experiment and placebo groups were evaluated with a Verbal Rating Scale (VRS) at the 30th minute and the 3rd hour after the application. Similarly, the pain level of patients in the control group was also evaluated with the VRS at 3 hours after the initial analgesic administration and following the 30th minute and the 3rd hour. Generally, the VRS scores of the 3 groups did not show a significant difference in terms of group and time interaction (P = .221). However, there was a significant difference in VRS scores between the experimental and control groups at the 30th minute after the massage (P = .036). This difference was caused by the lower pain level of the group, which had massage with lavender (2.66 ± .89) compared with the control group (3.80 ± 1.01). According to the study results, while only hand massage application after gynecologic surgery was effective for a short period in decreasing postoperative pain, it was determined that massage application with lavender had a longer effect in decreasing postoperative pain. The results of this study showed that this inexpensive and easy-to-apply method can be safely performed by nurses on postoperative patients and can support pain management of patients in the first hours after gynecologic surgery.

Mindfulness-Based Stress Reduction for Health Care Staff: Expanding Holistic Nursing Paradigms to the Whole System.

Abstract: Mindfulness-based stress reduction (MBSR) is a well-known mindfulness meditation program for patients that also may benefit health care providers and clinic staff themselves. An abbreviated MBSR program adapted into 6 weekly 75-minute sessions held during staff lunch breaks provided a feasible and acceptable staff training approach within the workplace setting.