Background:Test anxiety often leads to poor academic performance. This study aimed to determine the effect of computer-based tests on nursing students’ test anxiety.Methods:This quasi-experimental study was conducted in 2016 on 39 nursing student with anxiety score under 128 on Spielberger’s State-Trait Inventory (STAI). They were randomly allocated to computer-based tests (CBT) and paper-based test (PBT) group. Prior to exam, all students completed Sarason’s Test Anxiety Scale (TAS). We administered CBT for students in experimental group. Data were analyzed using independent t-test and one-way ANOVA.Results:Students mean test anxiety score was 11.94 and 11.32 in CBT and PBT groups, respectively. 47.4% of students in CBT group and 29.4% of those in PBT group experienced higher test anxiety, while the difference was not significant (p=0.56).Conclusions:Despite, there was no significant difference between anxiety score of two groups; but students’ test anxiety score was higher in CBT group. With the current increase in computer-based assessment, educational administrators must be aware of and plan for the possible unfavorable effects of computer assisted testing, such an anxiety. Future studies are needed to evaluate and compare the effect of different type of student testing such as distance testing or CBTs using new information technologies such as laptop, tablet or mobile phone on students’ test anxiety and performance.
Background and aims Pain management is one of the most important responsibilities of nurses in an intensive care unit (ICU). It is difficult to perform pain assessment appropriately in patients who are unable to report their pain. This study is aimed to determine the impact of implementing the critical care pain observation tool (CPOT) on the amount and frequency of analgesics' administration in ICUs. Materials and methods This interventional study was conducted in 2014. Sixty nurses and 240 patients were studied. This study was carried out in three phases: first the data about amount and frequency of analgesic administration were extracted from patients' medical files. Then the CPOT was implemented into the nursing assessment process and finally, nurses' performance regarding the amount and frequency of analgesic administration was recorded. This data obtained before and after intervention were analyzed using chi-square and independent t-test p values less than 0.05 were considered significant. Results In this interventional study, we found that there was no difference in the demography and cause of ICU admission before and after implementation of CPOT (age p = 0.937, gender p = 0.996, and the cause of admission p = 0.996). We found that after implementing the CPOT into the nursing assessment process, the amount of analgesics administered (7.95 ± 8.77 mg vs. 11.01 ± 11.04 mg, p = 0.018) and the frequency of administration (2.91 ± 1.38 vs. 4.16 ± 0.99, p <0.001) increased significantly. Moreover, there was a significant increase in the frequency of pain assessment per patient per day in nursing practice after implementation of CPOT as compared to the practice before (7.2 ± 2.48 vs. 1.03 ± 1.63, p <0.001). The mean pain scores before and after the intervention (5.5 ± 1.08 vs.2.2 ± 0.48) were also significantly different. Conclusion Applying CPOT, as an objective mean of pain assessment, was effective in improving the performance of ICU nurses in assessment and management of patients' pain. It increased the amount and frequency of analgesic administration. We can recommend that COPT is a useful tool for assessment and management of pain in ICU patients and should be implemented in all ICUs. How to cite this article Modanloo M, Mohsenpour A, et al. Impact of Implementing the Critical Care Pain Observation Tool on Nurses' Performance in Assessing and Managing Pain in the Critically Ill Patients. Indian J Crit Care Med 2019;23(4):165-169.
Sleep is an essential need for patients admitted to coronary care units. The present clinical trial aimed to determine the effect of using eye masks and earplugs on the sleep quality of patients with coronary heart disease (CHD). A total of 68 eligible patients with CHD were randomly allocated into four groups of 17 (control, eye masks, earplugs, and eye masks with earplugs). All three interventions were performed during the night from 10:00 p.m. to 7:00 a.m. the next day. The outcomes were the quality of sleep, measured by the Verran and Snyder-Halpern (VSH) Sleep Scale, and the urinary levels of nocturnal melatonin and cortisol, measured by urine samples taken during the night (from 10:00 p.m. to 7:00 a.m.). The study outcomes were measured on the third and fourth days. Sleep disturbance was statistically significantly lower in patients with earplugs (visual analogue scale mean difference [MD]: 74.31 mm, SE:11.34, p = 0.001). Sleep effectiveness was statistically significantly higher in patients with eye mask (MD: 36.88 mm, SE: 8.75, p = 0.001). The need for sleep supplementation was statistically significantly lower in patients with eye masks (MD: 39.79 mm, SE: 7.23, p = 0.001). There was a significant difference in melatonin levels between eye masks and the control group (p = 0.03). For urinary cortisol levels, there were significant differences between eye masks and the control group (p = 0.007), earplugs and the control group (p = 0.001), and eye masks with earplugs and the control group (p = 0.006). The mean scores for comfort, effectiveness, and ease of use were highest for the group that used eye masks (2.88, 2.94, and 3.18, respectively). As a result, all three interventions improved the sleep quality of patients. However, the interventions had different effects on the three dimensions of the VSH Sleep Scale, as well as the urinary levels of cortisol and melatonin.
Background: Cancer is one of the most important health problems, which cause anxiety. Owing to physical and psychological problems it may lead to thinking about impending death. Logotherapy is the most powerful method to treat problems that exist in nature. Objectives: This study aimed to determine the effect of group logotherapy on spirituality and death anxiety in patients with cancer. Methods: This randomized clinical trial study was done on patients with cancer referred to Imam Khomeini Hospital in Sari in 2017. Sixty-four eligible patients were selected from the oncology clinic using convenience sampling method. Patients were randomly allocated to the control and intervention groups (n = 32). Group logotherapy was done for the intervention group for five weeks. Data was gathered through a questionnaire, including demographic, Templer Death Anxiety Scale (DAS), and Spirituality Questionnaire (SQ) one week before and one week after the intervention. Data were analyzed in SPSS V. 16 software using independent t-test, Wilcoxon, and Mann-Whitney U test. The significant level was considered 0.05. Results: There were no significant differences in death anxiety and spirituality scores between the two groups at baseline, indicating that the two groups were matched in terms of death anxiety and spirituality. Before the logotherapy, the mean score of death anxiety in both groups was high (more than 8). After the logotherapy, the mean and SD of death anxiety score in the intervention and control groups were 7.14 ± 4.12 and 9.76 ± 2.64, respectively, there were statistically significant differences in death anxiety scores between the groups (P < 0.05). There were statistically significant differences between the mean of spirituality score in the intervention group before and after the logotherapy (P < 0.05), but it was not significant in the control group, indicating that group logotherapy was effective in increasing the spirituality score. Conclusions: Based on the findings, group logotherapy can increase the spirituality score of the patients. Moreover, the logotherapy may result in decreasing death anxiety, and spirituality-oriented meetings may be beneficial for patients.
Background and Aims:The use of weaning predictive indicators can avoid early extubation and wrongful prolonged mechanical ventilation. This study aimed to determine the power of the integrative weaning index (IWI) in predicting the success rate of the spontaneous breathing trial (SBT) in patients under mechanical ventilation.Materials and Methods:In this prospective study, 105 patients undergoing mechanical ventilation for over 48 h were enrolled. Before weaning initiation, the IWI was calculated and based on the defined cutoff point (≥25), the success rate of the SBT was predicted. In case of weaning from the device, 2-h SBT was performed and the physiologic and respiratory indices were continuously studied while being intubated. If they were in the normal range besides the patient's tolerance, the test was considered as a success. The result was then compared with the IWI and further analyzed.Results:The SBT was successful in 90 (85.7%) and unsuccessful in 15 (14.3%) cases. The difference between the true patient outcome after SBT, and the IWI prediction was 0.143 according to the Kappa agreement coefficient (P < 0.001). Moreover, regarding the predictive power, IWI had high sensitivity (95.6%), specificity (40%), positive and negative predictive values (90.5% and 60), positive and negative likelihood ratios (1.59 and 0.11), and accuracy (86.7%).Conclusion:The IWI as a more objective indicator has acceptable accuracy and power for predicting the 2-h SBT result. Therefore, in addition to the reliable prediction of the final weaning outcome, it has favorable power to predict if the patient is ready to breathe spontaneously as the first step to weaning.
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