2026-08-08T14:24:06+03:30 http://jccs.yums.ac.ir/browse.php?mag_id=8&slc_lang=en&sid=1

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 3 M. Gholami kalus M. Zarei nezhad M. Malekzadeh N. Hashemi Mohamadabad Sh. Najafi Doulatabad Aims: Rheumatoid arthritis is the most common inflammatory arthritis in adults, and fatigue is one of its most common symptoms. This study aimed to determine the effect of combining conservation of energy resources strategies and Hatha yoga on fatigue severity in patients with rheumatoid arthritis. Methods: This clinical trial study was carried out on all eligible patients with rheumatoid arthritis referred to Shahid Beheshti Hospital and private clinics in Yasouj, Iran, in 2020-2021. Seventy-five patients were selected by convenience sampling method and then randomly assigned to three intervention groups (energy saving strategies, Hatha yoga, combined energy-saving strategy, and Hatha yoga). Data were collected through the Multidimensional Fatigue Inventory questionnaire in three intervention groups in the first session before and after the intervention. Data were analyzed using SPSS 25 software through one-way analysis of variance. Findings: There was no significant difference in the mean score of fatigue severity between study groups before the intervention (p<0.05). A significant decrease was observed in the mean score of fatigue (p>0.001) in the combined methods of Hatha yoga and conservation of energy resources strategies (32.3±78.76) than Hatha Yoga (38.28±2.66) and conservation strategies of energy resources groups (42.52±3.83). Conclusion: Conservation of energy resources, Hatha yoga and a combination of conservation of energy resources, and Hatha yoga, improved fatigue severity in patients with rheumatoid arthritis, and the combined intervention was more effective than the other two methods.   Key Words: Conservation of Energy Resources Yoga Fatigue Rheumatoid Arthritis 2021 9 01 103 108 http://jccs.yums.ac.ir/article-1-106-en.pdf 10.52547/jccs.2.3.103

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 3 P. Eslamnik A. Makari H. Rezaei Aims: Isolated torsion of the fallopian tube is a rare condition. A case of isolated torsion of the left fallopian tube associated without anomaly and pathology was present. Patient & Methods: The patient was 17-year-old nulligravid from Yasuj who came to the obstetric department with acute severe abdominal pain, nausea, and vomiting in 2021. Her medical history included a left side ovarian cystectomy one year before admission. The pregnancy test was negative. Transvaginal ultrasonography showed a hemorrhagic cyst structure measuring 4cm in the left adnexa with moderate free fluid in the cul-de-sac was noted; the ovaries and uterus were unremarkable. Due to acute abdominal pain, an exploratory laparotomy was done and confirmed the diagnosis of isolated torsion of the left oviduct. The ipsilateral ovary appeared normal, but the fallopian tube was gangrenous, and left salpingectomy was performed. Findings: Due to acute abdominal pain, an urgent laparotomy was performed, which revealed a twisted left fallopian tube and confirmed the isolated torsion of the left oviduct. The ipsilateral ovary appeared normal, but the fallopian tube was gangrenous, and left salpingectomy was performed, and she was discharged from our hospital two days later. Conclusion: Women, without any abnormality and pathology of the tube, with a history of ovarian cyst surgery at the antimesenteric level, that the ovarian fimbria was removed are at risk for fallopian tube torsion. Fallopian Tubes Torsion Abnormality Abdominal Pain Gynecology 2021 9 01 109 111 http://jccs.yums.ac.ir/article-1-108-en.pdf 10.52547/jccs.2.3.109

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 3 H. Zarida A. Zarifi M. Zoladl M. Salari Aims: Nursing students should be equipped with higher thinking strategies such as metacognitive and lifelong learning skills to make correct decisions in new situations. This study was conducted to compare the effect of different problem-based learning methods on metacognitive skills in nursing students. Methods: In this quasi-experimental study with pretest-posttest design, the subjects were undergraduate students enrolled in the Pediatric Nursing II course at Islamic Azad University in Iran. Ninety-five nursing students were selected by multistage cluster sampling method and divided into Pure Problem-Based Learning (n=30), Hybrid Problem-Based Learning (n=30), and Lecture-Based Method (n=35). The intervention was conducted for eight weeks, during which the participants met once a week. Data were collected using the Metacognitive Awareness Inventory before and after each instructional method and analyzed in SPSS 17 software using the ANCOVA. Findings: A statistically significant difference was observed between the mean scores of overall metacognitive awareness for Pure Problem-Based Learning, Hybrid Problem-Based Learning, and Lecture-Based Method groups (p<0.01) and its sub-scales of knowledge of cognition and regulation of cognition (p<0.001) on the posttest. The mean score of metacognitive awareness for the Lecture-Based Method group was significantly lower than those of the Pure Problem-Based Learning and Hybrid Problem-Based Learning groups (p<0.05). Conclusion: Both Pure Problem-Based Learning and Hybrid Problem-Based Learning effectively enhance metacognitive skills in nursing students. Problem-Based Learning Lecture Metacognitive Awareness Nursing 2021 9 01 113 120 http://jccs.yums.ac.ir/article-1-102-en.pdf 10.52547/jccs.2.3.113

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 3 R. Taheri A.k. Alamdari A. Afrasiabi far M.L. Rastian Aims: Diabetes can be controlled by exercise, diet, and medication regimen, and training is essential for adherence to regimen therapy. This study aimed to compare the effect of training by face-to-face method and educational booklet on adherence to regimen therapy in patients with type 2 diabetes. Materials & Methods: This clinical trial study was carried out on 120 eligible patients. The subjects were selected by available sampling and classified into three groups: two intervention groups and a control group. The demographic information form and the diabetes adherence questionnaire were used to collect the information. Patients in the two intervention groups have received the intervention with the same content but different teaching methods. Data were analyzed by SPSS 21 software using Chi-square, analysis of variance, paired T, and Tukey tests. Findings: There was no statistically significant difference between the three groups in the mean scores of adherence to the regimen therapy and all its dimensions such as diet regimen, exercise regime, and medication regimen, before the intervention (p>0.05), but a significant difference was observed between the mean scores of diet regimen and exercise regime between the groups, after the intervention (p<0.05). However, there was no significant difference between the study groups in the mean adherence score to the medication regimen (p>0.05). Conclusion: Both face-to-face training and educational booklet were able to improve the dimensions of adherence to the treatment regimen in diabetes. However, the effect of face-to-face training and educational booklet on the dimensions of adherence to the treatment regimen was the same. Education Educational booklet Face to Face Education Medicin Adehrecence Therapy Type 2 Diabetes 2021 9 01 121 127 http://jccs.yums.ac.ir/article-1-103-en.pdf 10.52547/jccs.2.3.121

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 3 Z. Daneshyar N. Rahimi Aims: This study aimed to evaluate the diagnostic and laboratory findings of infections caused by acute coronavirus syndrome 2 (SARS-CoV-2). Information & Methods: This systematic review was carried out using research in Google Scholar, international databases such as Pubmed, Wiley, and Sciencedirect, and Iranian databases including SID and Magiran by the keywords SARS-CoV-2, COVID-19 diagnostic methods, PCR, COVID-19, and hematology parameters. Finally, 93 articles were selected and reviewed. Findings: Reverse transcription-polymerase chain reaction and molecular test methods are the method of choice to diagnose the cause of SARS-CoV-2 infection. Serological testing is not yet sensitive enough and specific for diagnosis. The clinical spectrum of the infection is wide, including asymptomatic infection, relatively mild upper respiratory tract disease, and severe viral pneumonia with respiratory failure and even death. The incidence of lymphopenia, thrombocytopenia, and coagulation disorders occur in severe cases of the disease and are associated with a poor prognosis. An increase of D-dimer levels in severe cases of the disease suggests anticoagulant therapy. In severe disease, laboratory tests show changes in the immune system with overstimulation of the cytokine storm. In addition, biomarkers of specific organs indicate heart, kidney, and liver dysfunction in many patients. Conclusion: Although virus detection by reverse transcription-polymerase chain reaction is the gold standard, if the test is negative, the definitive diagnosis of COVID-19 should be based on clinical data; other tests for complications of the disease are also important. SARS-CoV-2 Polymerase Chain Reaction Hematology 2021 9 01 129 138 http://jccs.yums.ac.ir/article-1-110-en.pdf 10.52547/jccs.2.3.129

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 3 Sh. Sehat Nejad A. Pour Samad M. Behnam Moghadam A. Mousavi zadeh N. kaidani Aims: Patients with Multiple Sclerosis face many problems and complications; fatigue and insomnia are considered the common complications influencing their lives. Complementary therapies such as reflexology and effleurage massage can help reduce fatigue and insomnia in these patients, but no comparison has been made between the two effects on reducing these complications. The present study compared reflexology and effleurage massage on the severity of fatigue and insomnia among Multiple Sclerosis patients. Methods: This experimental study is a clinical trial and conducted on 90 Multiple Sclerosis patients in Ahvaz city in Iran from May 30 to July 30, 2019. The selected patients were assigned into three groups: reflexology massage, effleurage massage, and control (group 30) by blocked randomized sampling). The intervention was performed in the reflexology and effleurage groups twice a week for eight weeks. The control group received only routine medication prescribed by the pertinent physician. The data were collected using a demographic questionnaire, Fatigue Severity Scale (FSS), and Insomnia Severity Index (ISI) before and after the intervention. The data were analyzed by SPSS 21 software, using descriptive statistics, Chi-square test, independent t-test, pair t-test, and Scheffe post hoc test. Findings: Following the intervention, there was a significant difference between the three groups (p≤0.001), but the reflexology intervention has a greater effect on fatigue severity among the patients than the effleurage massage. The results indicated that the effect of interventions on fatigue severity was the same in both groups of reflexology and effleurage (p=0.069); however, compared to the control group, insomnia severity diminished in reflexology and effleurage massage groups (p≤0.001). Conclusion: Applying reflexology and effleurage massage therapy techniques can be helpful to reduce the severity of fatigue and insomnia in Multiple Sclerosis patients, but reflexology is more effective in reducing insomnia. Accordingly, these techniques are suggested as effective, safe, and inexpensive nursing interventions.   Multiple Sclerosis Reflexology Massage Fatigue Insomnia 2021 9 01 139 144 http://jccs.yums.ac.ir/article-1-111-en.pdf 10.52547/jccs.2.3.139

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 3 S. Zabolypour A. Afrasiabifar S. Mohammadi M. Farzannia Aims: Sleep is one of the basic physiological needs of human beings, and sleep quality is an effective criterion on the quality of life of hemodialysis patients. Therefore, paying attention to sleep and its improvement should be a priority in nursing care. This study aimed to determine the effect of increasing the pumped blood volume delivered to dialyzer on sleep quality in hemodialysis patients. Materials & Methods: This semi-experimental study is a clinical trial carried out on 50 hemodialysis patients referred to the hospitals affiliated with Tehran University of Medical Sciences in 2011. Convenience sampling selected samples and randomly divided them into control and intervention groups through permuted block randomization. Data were collected by Pittsburgh Sleep Quality Index in the three stages before intervention and 2 and 4 weeks after intervention. The blood volume delivered to the dialyzer increased by 25ml in the first two weeks and 50ml in the second two weeks compared to before the intervention. Data were analyzed by SPSS 21 software using repeated measures ANOVA and Kruskal-Wallis test.  Findings: The mean score of sleep quality in the intervention group before the intervention and two and four weeks after the intervention were 10.2±2.6, 8.8±3.4 and 6.9±2.9, respectively and in the control group were 11.4±2.8, 12.5±3.3, and 12.6±3.4, respectively. There was no significant difference in the total score of sleep quality and some of its dimensions between the intervention and control groups (p<0.05). Conclusion: Increasing blood volume delivered to the dialyzer has improved hemodialysis patients' sleep quality, and this improvement seems to be clinically significant. Sleep Hemodialysis Patient 2021 9 01 145 150 http://jccs.yums.ac.ir/article-1-112-en.pdf 10.52547/jccs.2.3.145

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 3 D. Razmjoue S. S. Khoramrooz M. Jafari Lagharaki S. Jafari Lagharaki S. Nooripour Sisakht M. Zoladl Gh.A. Sabz Aims: Sinusitis is the inflammation of the nasal cavity, and Paranasal sinuses occur by pathogen agents such as bacteria, viruses, fungi, or other allergens. This study was aimed to determine the prevalence of positive fungal cultures in patients with chronic sinusitis undergoing functional endoscopic sinus surgery.  Materials & Methods: This experimental study was carried out on 60 patients with chronic sinusitis in 2019. After anesthesia in the operating room, the ENT specialist evacuated the sinuses of patients with chronic sinusitis undergoing sinus endoscopic surgery. After sampling of evacuated sinus tissue of eligible patients and transfer to mycology laboratory, fungal elements were identified using direct smear and culture of the sample on sub-dextrose agar medium. The patient's profiles were recorded. Data were analyzed using SPSS 21 software by the descriptive statistic. Findings: 36 of selected patients with chronic sinusitis were male (60%), and 24 were female (40%) with a mean age of 38.4±11.5 years. Two Candida parapsilosis (3.3%), one Aspergillus flavus (1.7%), and one Aspergillus niger (1.7%) were detected. Therefore, the prevalence of positive fungal cultures in patients with chronic sinusitis undergoing endoscopic sinus surgery was 6.7% in Yasuj, southwest of Iran, in 2019. Conclusion: The prevalence of fungal sinusitis is low in patients with chronic sinusitis in Yasuj due to the location of Yasuj in a mountainous region with a cold and dry climate. Sinusitis Fungi Prevalence 2021 9 01 151 155 http://jccs.yums.ac.ir/article-1-109-en.pdf 10.52547/jccs.2.3.151