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and purpose: This study aimed to investigate the effect of melatonin on sleep quality and cognitive function of individuals undergoing hemodialysis. In this randomized controlled clinical trial, 102 eligible individuals were assigned to two equal intervention and control groups. The intervention group received melatonin 3 mg tablets half an hour before going to bed for six weeks, while the control group was given a placebo with similar conditions. This study had 102 participants who were divided into intervention and control groups. The mean age of the participants was 58.30 (SD = 12.10). Among the participants, 54.90% were female. Moreover, 33.33% of the individuals received dialysis for four years or longer. After the intervention, the mean and standard deviation of the Pittsburgh Sleep Quality Index (PSQI) was 12.66 (SD = 3.09) in the intervention group and 18.86 (SD = 3.8) in the control group (P < 0.001). Moreover, the mean sleep quality index in the intervention group showed a statistically significant difference before and after the intervention (P < 0.001); the PSQI score declined from 20.21 to 12.66. Likewise, there was a statistically significant difference between the two groups after intervention in the mean Montreal Cognitive Assessment (MoCA) index (P = 0.002); it was 24.27 (SD = 3.42) in the intervention group and 22.15 (SD = 2.3) in the control group. The mean MoCA score in the intervention group showed a significant difference before and after the intervention (P < 0.001), increasing from 21.19 to 24.27. According to the study's findings, melatonin can improve individuals undergoing hemodialysis' cognitive function and sleep quality. • After the intervention, the mean and standard deviation of the Pittsburgh Sleep Quality Index was 12.66 (SD = 3.09) in the intervention group and 18.86 (SD = 3.8) in the control group (P < 0.001). • The mean sleep quality index in the intervention group showed a statistically significant difference before and after the intervention (P < 0.001); the PSQI score declined from 20.21 to 12.66. • There was a statistically significant difference between the two groups after intervention in the mean Montreal Cognitive Assessment index (P = 0.002); it was 24.27 (SD = 3.42) in the intervention group and 22.15 (SD = 2.3) in the control group. • The mean MoCA score in the intervention group showed a significant difference before and after the intervention (P < 0.001), increasing from 21.19 to 24.27. • Mmelatonin can improve individuals undergoing hemodialysis' cognitive function and sleep quality. [ABSTRACT FROM AUTHOR]

Burn patients feel a lot of physiological and mental stress during treatment and rehabilitation which often cause anxiety and body image dissatisfaction. This study aimed to compare the effects of the Benson relaxation technique and nature sounds on pain anxiety and body image in burn-injured patients admitted to a burn intensive care unit (BICU). This single-blind randomized clinical trial studied 60 burn patients allocated into three groups (Benson relaxation, nature sounds, and control) from September 2021 to February 2022. The patients received the intervention for seven consecutive days in person. Burn Specific Pain Anxiety Scale (BSPAS), was completed on the 1st, 4th, and 7th days. The intervention continued for four weeks measuring body image using the Satisfaction with Appearance Scale (SWAP) at the end of the 1st, 3rd, and 5th weeks. Finally, the data were statistically analyzed using the Shapiro–Wilk test, chi-square test, Fisher's exact test, Bonferroni post hoc test, repeated measures ANOVA, Kruskal Wallis test, and Generalize Estimating Equations (GEE). The mean pain anxiety and dissatisfaction with the appearance were high in the three groups in the pretest. On the 7th day after the intervention, the ANOVA showed that the mean pain anxiety decreased significantly in Benson's relaxation and nature sounds groups in three stages (before intervention (S1), after intervention (S2) and immediately after dressing change (S3) (P < 0.001). Correspondingly, the Kruskal Wallis test revealed that the body image dissatisfaction decreased significantly in the three groups at the end of the 3rd and 5th weeks (P < 0.001). The mean scores of pain anxiety showed that the nature sounds group proved more effective than the Benson relaxation technique. Also, the means scores of body image satisfaction showed that the Benson relaxation technique proved more effective than nature sounds. The study findings suggested that the Benson relaxation technique and nature sounds effectively reduces pain, anxiety, and improves body image satisfaction in patients with burn injuries. • This single-blind randomized clinical trial study was conducted on burn patients hospitalized in the intensive care unit. • The evaluator nurse, unaware of the kind of intervention for each patient, completed the questionnaires. • The mean scores of pain anxiety showed that the nature sounds proved more effective than the Benson relaxation technique. • The mean scores of body image showed that the Benson relaxation technique proved more effective than nature sounds. [ABSTRACT FROM AUTHOR]

Background: Pain is a common phenomenon after surgery. Cardiac surgeries are no exception and patients generally experience acute pain after these surgeries. Inadequate pain management after cardiac surgery predisposes patients to many complications. Therefore, the aim of this study was to determine the effects of listening to preferred music on pain intensity after open heart surgery. Materials and Methods: This study was a randomized clinical trial (RCT) conducted in open heart intensive care unit (ICU) of a university hospital in Sari, Iran. A total of 60 patients who were scheduled to undergo open heart surgery were randomly allocated in two groups. Patients in the intervention group (n = 30) listened to their preferred music by headphones for 30 minutes, whereas those in the control group (n = 30) did not listen to music. Using a Numerical Rating Scale (NRS), pain intensity was measured among the patients before the intervention, and immediately, 30 minutes and one hour after the intervention. Data was analyzed by Chi-square test, student's t-test and repeated measures analysis of variance (ANOVA). Findings: Mean pain intensity in the intervention group before, immediately after, 30 minutes and one hour after the intervention were 5.8, 3.1, 2.5 and 2.4, respectively. Corresponding numbers in the control group were 4.7, 4.7, 4.8 and 4.9, respectively. Repeated measures ANOVA showed music to significantly reduce pain intensity (p = 0.0001) Conclusions: Music can be effective as a non-pharmacological, inexpensive, non-invasive and side effect free method for pain management after open heart surgery. [ABSTRACT FROM AUTHOR]

Background and purpose: The monitoring of the patients' hemodynamic status and vital signs is a routine practice in ICU and the use of a low-cost and soothing method to maintain stable physiological parameters is necessary. This study aimed at investigating the effect of music on the vital signs and SpO2 of patients after open heart surgery. Materials and methods: This study was a randomized clinical trial (RCT) conducted on 60 patients hospitalized in the open heart surgery ICU of Mazandaran Heart Center. Patients were randomly assigned into case and control groups. In the case group, the patients listened to the music, which they selected before, through headphones for 30 minutes, while headphones without playing any music were used for patients in the control group. Vital signs and SpO2 of the patients were assessed before the intervention, immediately, 30 and 60 minutes after the intervention. The data were analyzed using Chi-square; T -test and repeated measure statistical tests. Results: Findings showed that music led to a significant decrease in the rate of heart beat, systolic blood pressure, and mean arterial pressure and a significant increase in SpO2 rate (P<0.05) was also observed. But music had no significant effect on the respiratory rate and diastolic blood pressure (P>0.05). Conclusion: As a non-pharmacologic, inexpensive, non-invasive method and without any side effects, music can improve the vital signs of the patients after open heart surgery. [ABSTRACT FROM AUTHOR]

The present study aimed to evaluate the effect of an empowerment program on the moral sensitivity and caring behaviors of nurses in emergency departments in Iran. Emergency department is often a high stress environment. Nurses who worked in the emergency departments are expected to work under pressure to many standards, guidelines and protocols related to patient care. It will expose emergency department nurses to psychological pressures and moral conflicts. A nurse's sensitivity to ethical issues is necessary to provide humane care; it is considered to be a professional competence for nurses. This study had a controlled quasi-experimental design. Data were collected before, immediately after, and 1 month after the intervention using a moral sensitivity questionnaire and a caring behavior questionnaire. A total of 131 emergency department nurses from 4 teaching hospitals were divided into an intervention group and a control group. The intervention group received six 60-minute training sessions; the control group did not receive the training. The mean moral sensitivity and caring behavior scores for both groups increased significantly immediately and 1 month after the intervention. However, the significance was higher in the intervention group than in the control group. A comparison of the mean moral sensitivity and caring behavior scores between the groups immediately and 1 month after the intervention did not show a statistically significant difference. Implementing a training program on ethical issues could thus have a significant impact on the clinical performance of nurses, which could be maintained through follow-up. • Nurses need to be able to make ethical decisions when faced with ethical problems. • Many barriers affect the moral sensitivity of nurses in practice. • Lack of moral sensitivity in nurses can negatively affect quality of care. • The ethical empowerment program can enhance the moral sensitivity of nurses. • The ethical empowerment program can improve the caring behaviors of nurses. [ABSTRACT FROM AUTHOR]