The effects of slow-stroke back massage on anxiety and shoulder pain in elderly stroke patients

This study explores the effect of slow-stroke back massages on anxiety and shoulder pain in hospitalized elderly patients with stroke. An experimental quantitative design was conducted, comparing the scores for self-reported pain, anxiety, blood pressure, heart rate and pain of two groups of patients before and immediately after, and three days after the intervention. The intervention consisted of ten minutes of slow-stroke back massage (SSBM) for seven consecutive evenings. One hundred and two patients participated in the entire study and were randomly assigned to a massage group or a control group. The results revealed that the massage intervention significantly reduced the patients' levels of pain perception and anxiety. In addition to the subjective measures, all physiological measures (systolic and diastolic blood pressures and heart rate) changed positively, indicating relaxation. The prolonged effect of SSBM was also evident, as reflected by the maintenance of the psycho-physiological parameters three days after the massage. The patients' perceptions of SSBM, determined from a questionnaire, revealed positive support for SSBM for elderly stroke patients. The authors suggest that SSBM is an effective nursing intervention for reducing shoulder pain and anxiety in elderly patients with stroke. From a nursing perspective, this nursing practice provides a challenge and an opportunity for nurses and family caregivers to blend alternative therapies with technology to provide more individualized and holistic patient care.     

Massage as adjuvant therapy in the management of post-cesarean pain and anxiety: A randomized clinical trial

ObjectiveThe present study was conducted to determine the effect of massage on post-cesarean pain and anxiety.MethodsThe present single-blind clinical trial was conducted on 156 primiparous women undergone elective cesarean section. The participants were randomly divided into three groups, including a hand and foot massage group, a foot massage group and a control group (n = 52 per group). The patients' intensity of pain, vital signs and anxiety level were measured before, immediately after and 90 min after the massage.ResultsA significant reduction was observed in the intensity of pain immediately and 90 min after massage (P < 0.001). Moreover, changes in some of the physiological parameters, including blood pressure and respiration rate, were significant after massage (P < 0.001); however, this change was not significant for pulse rate. A significant reduction was also observed in the level of anxiety (P < 0.001) and a significant increase in the frequency of breastfeeding (P < 0.001) after massage.ConclusionAs an effective nursing intervention presenting no side-effects, hand and foot massage can be helpful in the management of postoperative pain and stress.     

Oxygen desaturation in women in labor

Oxygen saturation and end-tidal CO2 tension were monitored in 15 healthy women during labor. Oxygen saturation was determined with a pulse oximeter and end-tidal CO2 with a CO2 monitor. Fetal heart rate, uterine contractions and maternal blood pressure were also monitored. End-tidal CO2 tension was followed to determine if falls in oxygen saturation during labor were related to hyperventilation. Ten of the 15 patients exhibited periods of oxygen saturation of less than 90%. End-tidal CO2 was consistently low, usually less than 30 mm Hg. Most, but not all (7 of 10), of the patients who showed desaturation had received narcotics. There were often periods of apnea and/or shallow respirations between contractions. These aberrations and hyperventilation-induced hypocarbia were probably the cause of the oxygen desaturation. No changes in fetal heart rate or low Apgar scores were noted.     

The influence of physiological parameters on long term heart rate variability in healthy preterm infants

The instantaneous heart rate shows a variation around the mean heart rate caused by cardioregulatory mechanisms which are mediated through the sympathetic and vagal autonomic nervous system. To gain more insight into the influence of physiological parameters on neonatal heart rate variability a study was performed in four healthy preterm newborns during the first five days of life. Instantaneous heart rate, respiration rate, transcutaneous pO2, blood pressure and behaviour were recorded during 40 minutes four times a day. Long term heart rate variability was calculated as the difference between p95 and p5 of instantaneous heart rate values sampled during three minutes. A clear relationship between long term variability and age (maturity of the autonomic nervous system), respiration rate (respiratory sinus arrhythmia or a tidal volume mediated effect) and behaviour (increase of sympathetic tone during REM sleep) was found. No influence of blood pressure, heart rate, and transcutaneous pO2 within physiological ranges could be detected. The relative influence of the different physiological parameters on heart rate variability has to be established before the value of heart rate variability as a monitoring tool in neonatal intensive care can be investigated.     

Reflexology has an acute (immediate) haemodynamic effect in healthy volunteers: A double-blind randomised controlled trial

Reflexologists claim that massage to specific points of the feet increases blood supply to internal organs. This study measured changes in cardiovascular parameters in subjects receiving reflexology to areas of their feet thought to correspond to the heart (intervention) compared with other areas which are not (control).Method16 reflexology-naive healthy volunteers received an active and control reflexology treatment in an RCT, double-blind repeated measures study.Main outcome measures‘Beat-to-beat’ continuous measurement of selected cardiovascular parameters, State Anxiety Inventory.ResultsCardiac index decreased significantly in the intervention group during left foot treatment (LFT) (baseline mean 2.6; standard deviation (SD) 0.75; 95% CI ± 0.38 vs. LFT mean 2.45; SD 0.68; CI 0.35), effect size (p = 0.035, omega squared effect (w2) = 0.002; w = 0.045).ConclusionReflexology massage applied to the upper part of the left foot may have a modest specific effect on the cardiac index of healthy volunteers.     

The outcome of tactile touch on stress parameters in intensive care: a randomized controlled trial

The study aimed to investigate the effects of a five-day tactile touch intervention in order to find new and unconventional measures to moderate the detrimental influence of patients' stressors during intensive care. The hypothesis was that tactile touch would decrease stress indicators such as anxiety, glucose metabolism, blood pressure, heart rate and requirements of sedative drugs and noradrenalin. A randomized controlled trial was undertaken with 44 patients, which were assigned either to tactile touch or standard treatment (a rest hour). Observations of the stress indicators were made before, during and after the intervention or standard treatment. The study showed that tactile touch led to significantly lower levels of anxiety. The circulatory parameters suggested increased circulatory stability indicated by a reduction in noradrenalin requirement. The results need to be further validated through studies with larger sample sizes.     

Closed suctioning of intubated neonates maintains better physiologic stability: a randomized trial.

OBJECTIVE: To evaluate the physiological variance in a closed (CS) vs an open suction (OS) protocol in intubated infants. STUDY DESIGN: Infants were stratified into three weight groups in a randomized crossover trial. Heart rate, respiratory rate, blood pressure, oxygen saturation, transcutaneous oxygen and carbon dioxide, and end-tidal carbon dioxide were recorded prior to suctioning, during suctioning, and recovery to baseline. Following the procedures, recovery time to baseline parameters was measured. Data were analyzed using repeated measures ANOVA. RESULTS: Overall, there was significantly less deviation from baseline physiological parameters with CS. Infants <1000 g had clinically significant decreases in heart rate with the OS method (-18% OS vs -6% CS; p=0.016). Recovery time in the OS group was twice that of the CS cohort (4 vs 2 minutes; p<0.001). CONCLUSION: CS maintains better physiologic stability in intubated infants.     

呼吸内科重症患者的临床护理

目的：对呼吸内科重症患者的临床护理措施进行探讨。方法：选取呼吸内科重症患者68例,随机分为对照组与观察组各34例,对照组进行常规护理,观察组在常规护理的基础上从多方面展开精心护理,对比两组护理效果与血气分析指标变化情况。结果：观察组治愈率显著高于对照组,死亡率显著低于对照组（P〈0.05）。护理后,两组患者氧分压、二氧化碳分压、心率等各血气分析指标均有显著改善,且观察组改善情况显著优于对照组（P〈0.05）。结论：对于呼吸内科重症患者,在常规护理上从病情观察、药物、心理、环境与通气等方面给予精心护理,可促使临床治愈率显著提高,大幅降低患者死亡率,值得在临床中推广。     

The effects of family-friend visits on anxiety,physiological indices and well-being of MI patients admitted to a coronary care unit

ObjectiveTo investigate the effect of family-friend visits on anxiety, physiological indices and well-being of patients with acute myocardial infarction.MethodsA checklist was used to gather socio-demographic data and physiologic indices including blood pressure, heart rate, respiratory rate, and arterial oxygen saturation. The short-form of the Spielberger state anxiety inventory, a visual analog scale well-being and cardiac monitoring devices were used for collecting data.ResultsPatients exhibited a lower heart rate and respiratory rate in the normal range during the 10-min visiting period and within10 and 30 min after the visiting period. The arterial oxygen saturation increased in this period. After the visiting period, patients exhibited an increase in the sense of well-being and a decrease in the level of anxiety.ConclusionFamily-friend visits can improve MI patients' sense of well-being and decrease their anxiety. Moreover, the visits can help to keep the physiological indices within normal limits.     

The effects of foot and facial massage on sleep induction, blood pressure, pulse and respiratory rate: crossover pilot study

The study aimed to compare the effects of facial massage with that of foot massage on sleep induction and vital signs of healthy adults and to test a methodology that could be used by a lone researcher in such a study. A randomised within-group crossover pilot study of six healthy female volunteers was conducted. The interventions were a 20 min foot and a 20 min facial massage using peach-kernel base oil Prunus persica. A drop in systolic blood pressure of 8.5 mmHg was recorded immediately after facial massage compared to that of 1 mmHg recorded after foot massage. Both treatments were equally effective in reducing subjective levels of alertness during the interventions, with face massage marginally better at producing subjective sleepiness. A lone researcher using these methods would be able objectively to measure vital signs before and after interventions, but not during; and would be able subjectively to measure sleep induction in non-sleep-laboratory contexts.     

特布他林与硝苯地平用于产时胎儿宫内复苏:前瞻性随机对照研究

目的初步探索特布他林与硝苯地平用于产时胎儿宫内复苏(intrauterine fetal resuscitation,IUFR)的安全性及有效性。方法本研究采用随机对照方法,前瞻性将2021年1月至2021年4月在广州市妇女儿童医疗中心分娩中出现不可靠胎心监护图形(non-reassuring fetal heart rate tracing,NRFHT)的110例孕产妇随机分为特布他林组(硫酸特布他林0.25 mg皮下注射,n=55)和硝苯地平组(硝苯地平10 mg口服,n=55)。收集2组孕妇使用药物前及用药后5、15、30 min的血压、心率、血氧饱和度等血流动力学变化,以及IUFR的成功率、药物起效时间、产后出血率等指标,采用t检验、χ²检验、Fisher精确概率法及秩和检验对数据进行统计学分析。结果特布他林组和硝苯地平组孕妇用药前后平均动脉压及血氧饱和度比较差异均无统计学意义(P值均>0.05);硝苯地平组孕妇用药前后心率无明显变化(P>0.05),而特布他林组孕妇心率在用药后5、15、30 min均快于用药前[(97.0±20.2)、(99.2±13.8)、(91.8±12.6)与(81.7±11.3)次/min,P值均<0.001],但心率增快效应在30 min开始下降,与用药后15 min相比,心率下降了6.4次/min(95%CI:1.5~11.2,P<0.05)。所有孕产妇均未发生需要医疗干预的不良反应。特布他林组有78.2%(43/55)复苏成功,与硝苯地平组的70.9%(39/55)比较差异无统计学意义(χ²=0.77,P=0.381);特布他林组药物起效时间明显快于硝苯地平组[2 min(1~6 min)与6 min(1~10 min),U=2348.50,P<0.001]。2组孕产妇因NRFHT行剖宫产及阴道助产、1 h内再次使用宫缩抑制剂等方面比较差异均无统计学意义(P值均>0.05)。2组产后出血量、产后出血率、新生儿低Apgar评分(≤7分)、低脐动脉pH值(pH<7.2)、新生儿窒息率及新生儿重症监护病房入住率等方面差异均无统计学意义(P值均>0.05)。结论特布他林用于产时IUFR暂未发现明显不良反应;其起效速度快,可作为处理产时紧急IUFR的选择方案。     

Non‐nutritive Sucking for Preterm Infants in Egypt

ObjectiveTo assess how non‐nutritive sucking (NNS) using a pacifier affected physiological and behavioral outcomes of preterm infants.DesignShort‐term longitudinal, experimental design.SettingThe study took place at the neonatal intensive care unit at Al‐Mansoura, Egypt.MethodsForty‐seven preterm infants were divided into intervention and control groups. Preterm infants in the intervention group received NNS during nasogastric tube feeding while infants in the control group never received NNS. During 10 days, behavioral responses were videotaped and physiological responses were monitored.ResultsSignificantly higher oxygen saturation occurred during and after nasogastric feeding for the intervention infants as compared to the control group. No significant group differences occurred in heart rate. The NNS group showed an accelerated transition to nipple feeding and had better weight gain and earlier discharge.ConclusionNon‐nutritive sucking was found to improve physiological and behavioral responses of preterm infants.     

Intraperitoneal Pressures and Clinical Parameters of Total Paracentesis for Palliation of Symptomatic Ascites in Ovarian Cancer

Objective.The present study was designed to prospectively evaluate the intraperitoneal pressure, as well as clinical and hemodynamic effects of total paracentesis, as palliation of symptomatic ascites in ovarian cancer patients.Methods.Prospective study of 35 sequential total paracenteses was performed using a Veres cannula on patients with advanced recurrent ovarian cancer with symptomatic tense ascites. Relevant clinical symptoms and patient well-being were evaluated. Vital signs, abdominal parameters, and hydrostatic intraperitoneal pressure were recorded before, during, and after the procedure.Results.Intraperitoneal pressure dropped from 30 ± 7 cmH₂O before paracentesis to 13 ± 6 cmH₂O after the procedure (P< 0.0001). Marked symptomatic improvement was observed in all patients (89% complete relief, 11% partial relief), while all the patients tolerated the procedure well without any complications. The mean volume of ascitic fluid removed was 4800 ml. Mean respiratory rate and mean heart rate were both significantly decreased following the procedure (29.3 to 21.4 respirations per min and 101.5 to 93.6 beats per min, respectively). Mean systolic blood pressure mildly decreased (6.6 mmHg), while the mean diastolic blood pressure did not significantly change. None of the patients presented signs or symptoms of hypovolemia during or after the total paracentesis.Conclusions.Measurement of intraperitoneal pressures during total paracentesis for tense ascites in ovarian cancer patients indicated that the severity of symptoms correlated with the intraperitoneal pressure prior to paracentesis, but not with the volume of ascites. Intraperitoneal pressures measured following total paracentesis in patients with ovarian cancer were similar to the baseline intraperitoneal pressure measured in patients undergoing peritoneal dialysis.     

Caregiver delivered massage therapy options in inpatient palliative care: A mixed methods exploratory study

Backgroundand purpose: Massage therapy can benefit palliative care inpatients and this intervention could be provided by trained caregivers in this setting. This study aimed to determine the feasibility and acceptance of caregiver massage therapy, to explore patients' and caregivers’ experience of massage therapy, and examine staff perspectives about caregiver massage therapy in palliative care.Materials and methodsThis was a mixed methods, convergent, study design. Inpatient palliative care patients were offered massage provided by a caregiver, following training. Caregiver massage therapy was provided up to five days post training. Patients and caregivers completed self-report measures of satisfaction for the five-day intervention, while caregivers rated massage-related burden and confidence. Healthcare professionals working in inpatient palliative care participated in a focus group, during which enablers and barriers to caregiver massage therapy were explored.ResultsOver the three-month recruitment period, 62 participants were available for recruitment. Of these, 23 (37%) consented to caregiver massage. Caregiver burden was highest on day 2 (mean 2.9/5) while confidence was highest on day 4 (mean 4.1/5). Caregivers and patients were satisfied with the massage training sessions, and patients reported perceptions of comfort during subsequent sessions. Staff-identified enablers to caregiver massage therapy included patient symptom improvement and caregiver empowerment but considered caregiver massage potentially burdensome for caregivers.ConclusionCaregiver massage training is feasible, with a modest acceptance within an inpatient palliative care unit. Enablers of massage therapy in inpatient palliative care were caregiver empowerment, but this model was perceived as potentially burdensome for caregivers by healthcare professionals.     

Effects of music on physiological and behavioral responses of premature infants: A randomized controlled trial

IntroductionDespite persuasive theories about the beneficial effects of music and singing in developmental care for premature infants, few small studies are available in this regard. We conducted this study to investigate the physiological and behavioral responses of premature infants to recorded lullaby music and silence.MethodsIn a randomized controlled trial, 90 premature infants in the neonatal care unit of a hospital in Qom (Iran) were randomly allocated to intervention (lullaby and silence) or control groups. Lullaby music was played via headphones at a volume of 50–60 dB. In the silence group, headphones were placed on the infants' ears while no music was played. The three groups were surveyed for physiological responses including oxygen saturation, respiratory and heart rates, and behavioral states every five minutes before, during, and after the intervention.ResultsThe three groups were not significantly different in terms of mean values of respiratory and heart rates, oxygen saturation, and behavioral states of infants. Similarly, no significant within group differences in respiratory and heart rates, oxygen saturation, and behavioral states were observed at different times.ConclusionOur findings did not support the beneficial effects of music for premature infants. However, music is a noninvasive, non-pharmaceutical, and relatively low-cost intervention that can be implemented at infants' bedside. Thus further research is warranted to determine whether the effects noted in previous studies can be consistently replicated in diverse settings and with diverse groups of preterm infants.     

The effect of facilitated tucking position during endotracheal suctioning on physiological responses and coping with stress in premature infants: a randomized controlled crossover study

Abstract

Objective: Premature infants respond more intensively to pain compared with term infants. Facilitated tucking position as a non-pharmacological method of pain in infants has been suggested; however, its effect on acute procedural pain such as endotracheal suctioning remains to be studied. This study examined the effect of facilitated tucking position during suctioning on physiological responses and coping with stress in premature infants.

Methods: This was a randomized controlled crossover study. Thirty-four premature infants received an order of either suctioning with intervention – suctioning without intervention, or suctioning without intervention – suctioning with intervention. Neonatal Infant Pain Scale (NIPS) was used to collect the data.

Results: No statistical significant difference was seen between intervention and non-intervention cases in terms of the average time duration to reach the pain score to one or zero, and also, in the average of changes in oxygen saturation. However, changes in heart rate were less in intervention cases.

Conclusion: The effect of facilitated tucking position on coping with stress was not found in this study. This non-pharmacological strategy can be suggested because of its effect on reducing changes in heart rate during painful procedure. It is suggested to replicate the study with larger number of samples.     

Effects of prenatal music stimulation on fetal cardiac state,newborn anthropometric measurements and vital signs of pregnant women: A randomized controlled trial

BackgroundMusic has been used for medicinal purposes throughout history due to its variety of physiological, psychological and social effects.ObjectiveTo identify the effects of prenatal music stimulation on the vital signs of pregnant women at full term, on the modification of fetal cardiac status during a fetal monitoring cardiotocograph, and on anthropometric measurements of newborns taken after birth.Material and methodA randomized controlled trial was implemented. The four hundred and nine pregnant women coming for routine prenatal care were randomized in the third trimester to receive either music (n = 204) or no music (n = 205) during a fetal monitoring cardiotocograph. All of the pregnant women were evaluated by measuring fetal cardiac status (basal fetal heart rate and fetal reactivity), vital signs before and after a fetal monitoring cardiotocograph (maternal heart rate and systolic and diastolic blood pressure), and anthropometric measurements of the newborns were taken after birth (weight, height, head circumference and chest circumference).ResultsThe strip charts showed a significantly increased basal fetal heart rate and higher fetal reactivity, with accelerations of fetal heart rate in pregnant women with music stimulation. After the fetal monitoring cardiotocograph, a statistically significant decrease in systolic blood pressure, diastolic blood pressure and heart rate in women receiving music stimulation was observed.ConclusionMusic can be used as a tool which improves the vital signs of pregnant women during the third trimester, and can influence the fetus by increasing fetal heart rate and fetal reactivity.     

Effect of cutaneous stimulation on pain reduction in emergency department patients

CONTEXT: The problem of unrelieved pain in Emergency Department (ED) patients as well as contraindications to analgesics and narcotics due to masking of symptoms during the diagnostic period, presents itself as a unique opportunity for ED nurses to utilize non-pharmacological and non-invasive interventions such as cutaneous stimulation (CS) to relieve pain. OBJECTIVE: To evaluate the effectiveness of a specific protocol of CS, developed by the researchers, in reducing pain levels in ED patients. Another objective was to determine the effect of CS on blood pressure and heart rate. Potential factors that could influence the dependent variables such as age, gender, educational level, location of pain, and site of CS were tested. DESIGN: A one group pre-test post-test experimental design measured variables before and after intervention in all subjects. SAMPLE: After being screened for inclusion, 50 patients (38 adults, 12 children) were admitted to the study and were treated with CS to relieve pain. RESULTS: Following CS, subjects reported significantly reduced pain, and demonstrated reduced heart rate, and blood pressure readings. The location of pain significancy influenced heart rate and diastolic blood pressure but not pain level. The most effective site of CS was contralateral to the pain. Age, gender and educational level had no significant affect. CONCLUSIONS: The results of this study provide empirical evidence that CS effectively reduces pain, heart rate, and blood pressure in ED patients. The intervention of CS has solid utilization potential and could be easily incorporated into standard ED procedure. Further research is needed to identify threats to internal validity especially that of the caring presence of the nurse.