Effect of abdominal massage on prevention of aspiration in intubated and enterally fed patients: A randomized controlled trial

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Mahlagha Dehghan ◽  
Amanollah Fatehi Poor ◽  
Roghayeh Mehdipour-Rabori ◽  
Mehdi Ahmadinejad
Keyword(s):  
Intensive Care ◽  
Confidence Interval ◽  
Endotracheal Tube ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Respiratory Secretion ◽  
Intensive Care Patients ◽  
Randomized Controlled ◽  
Abdominal Massage

AbstractBackgroundAspiration is a serious side effect of delayed gastric emptying and increased residual volume in intensive care patients. Aspiration can increase the risk of pneumonia and death. Currently, pharmaceutical methods are the most commonly used techniques for decreasing aspiration, but non-pharmaceutical methods may also be effective in reducing aspiration. One of these methods is an abdominal massage. The present study aimed to examine the effect of abdominal massage on aspiration incidence in intensive care patients with an endotracheal tube.MethodsThis study was a randomized controlled clinical trial. Seventy intensive care patients with an endotracheal tube were chosen by convenience sampling and allocated to an intervention or a control group by the minimization method. The intervention group was provided with a 15-min abdominal massage twice a day for 3 days, while the control group received only routine cares. The patients’ respiratory secretion was suctioned before and after the intervention, and immediately after suctioning, the incidence of the aspiration was assessed using special strips which are sensitive to respiratory secretion pH and glucose. SPSS 18 was used to analyze data. Descriptive statistics were used. T independent, Mann-Whitney U, χ2, and Fisher exact tests were used to compare two groups.ResultsThe incidence rates of the aspiration were 5.7% (confidence interval: 0.0–14.3%) and 20% (confidence interval: 8.6–34.3%) in the abdominal massage and the control groups, respectively. The incidence of aspiration differed between two groups, but it was not statistically significant (p=0.07).ConclusionAlthough the low rate of aspiration in the abdominal massage group did not differ significantly with that of the control group, it can be clinically important. It is suggested that further studies be conducted to confirm the effect of abdominal massage on the prevention of aspiration in intensive care patients with an endotracheal tube.

scholarly journals App Technology to Support Physical Activity and Intake of Vitamins and Minerals After Bariatric Surgery (the PromMera Study): Protocol of a Randomized Controlled Clinical Trial (Preprint)

2020 ◽  
Author(s):  
Stephanie Erika Bonn ◽  
Mari Hult ◽  
Kristina Spetz ◽  
Marie Löf ◽  
Ellen Andersson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Bariatric Surgery ◽  
Controlled Trial ◽  
Intervention Group ◽  
Study Participant ◽  
Lifestyle Factors ◽  
Lifestyle Changes ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Randomized Controlled

BACKGROUND To optimize postoperative outcomes after bariatric surgery, lifestyle changes including increased physical activity are needed. Micronutrient deficiency after surgery is also common and daily supplementation is recommended. OBJECTIVE The aim of the PromMera study is to evaluate the effects of a 12-week smartphone app intervention on promotion of physical activity (primary outcome) and adherence to postsurgery vitamin and mineral supplementation, as well as on other lifestyle factors and overall health in patients undergoing bariatric surgery. METHODS The PromMera study is a two-arm, randomized controlled trial comprising patients undergoing bariatric surgery. Participants are randomized postsurgery 1:1 to either the intervention group (ie, use of the PromMera app for 12 weeks) or the control group receiving only standard care. Clinical and lifestyle variables are assessed pre- and postsurgery after 18 weeks (postintervention assessment), 6 months, 1 year, and 2 years. Assessments include body composition using Tanita or BOD POD analyzers, muscle function using handgrip, biomarkers in blood, and an extensive questionnaire on lifestyle factors. Physical activity is objectively measured using the ActiGraph wGT3X-BT triaxial accelerometer. RESULTS A total of 154 participants have been enrolled in the study. The last study participant was recruited in May 2019. Data collection will be complete in May 2021. CONCLUSIONS Implementing lifestyle changes are crucial after bariatric surgery and new ways to reach patients and support such changes are needed. An app-based intervention is easily delivered at any time and can be a key factor in the adoption of healthier behavioral patterns in this rapidly growing group of patients. CLINICALTRIAL ClinicalTrials.gov NCT03480464; https://clinicaltrials.gov/ct2/show/NCT03480464 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/19624

scholarly journals Effect of a Smartphone-Based App on the Quality of Life of Patients With Heart Failure: Randomized Controlled Trial

JMIR Nursing ◽  
10.2196/20747 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e20747
Author(s):  
Mahboube Davoudi ◽  
Tahereh Najafi Ghezeljeh ◽  
Farveh Vakilian Aghouee
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Patients With Heart Failure

Background Patients with heart failure have low quality of life because of physical impairments and advanced clinical symptoms. One of the main goals of caring for patients with heart failure is to improve their quality of life. Objective The aim of this study was to investigate the effect of the use of a smartphone-based app on the quality of life of patients with heart failure. Methods This randomized controlled clinical trial with a control group was conducted from June to October 2018 in an urban hospital. In this study, 120 patients with heart failure hospitalized in cardiac care units were randomly allocated to control and intervention groups. Besides routine care, patients in the intervention group received a smartphone-based app and used it every day for 3 months. Both the groups completed the Minnesota Living with Heart Failure Questionnaire before entering the study and at 3 months after entering the study. Data were analyzed using the SPSS software V.16. Results The groups showed statistically significant differences in the mean scores of quality of life and its dimensions after the intervention, thereby indicating a better quality of life in the intervention group (P<.001). The effect size of the intervention on the quality of life was 1.85 (95% CI 1.41-2.3). Moreover, the groups showed statistically significant differences in the changes in the quality of life scores and its dimensions (P<.001). Conclusions Use of a smartphone-based app can improve the quality of life in patients with heart failure. The results of our study recommend that digital apps be used for improving the management of patients with heart failure. Trial Registration Iranian Registry of Clinical Trials IRCT2017061934647N1; https://www.irct.ir/trial/26434

scholarly journals EFFECTIVENESS OF SUCTION ABOVE CUFF ENDOTRACHEAL TUBE (SACETT) IN PREVENTING VENTILATOR ASSOCIATED PNEUMONIA IN CRITICAL PATIENTS IN INTENSIVE CARE UNIT

2018 ◽  
Vol 4 (4) ◽  
pp. 380-389
Author(s):  
Arfiyan Sukmadi ◽  
Rr Sri Endang Pujiastuti ◽  
Aris Santjaka ◽  
Supriyadi Supriyadi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Endotracheal Tube ◽  
Intervention Group ◽  
Control Group ◽  
Ventilator Associated Pneumonia ◽  
Mechanical Ventilator ◽  
Control Group Design ◽  
Bacterial Development ◽  
Critical Patients

Background: The mechanical ventilator is an indispensable breathing tool in the Intensive Care Unit (ICU). But the mechanical ventilator is associated with the risk of Ventilator Associated Penumonia (VAP). VAP occurs due to poor hygiene of the endotracheal tube (ETT). ETT hygiene should be maintained to inhibit bacterial development in the lungs using suction above cuff endotracheal tube (SACETT) to prevent VAP.Objective: To analyze the effectiveness of SACETT in preventing Ventilator Associated Pneumonia (VAP) in critical patients in the ICU.Methods: This was a quasy experimental study with posttest only with control group design with 15 samples in intervention group (SACETT and Chlorhexidine 0.2%) and 15 in control group (ETT, Open Suction, and Chlorhexidine 0.2%) with purposive technique sampling. The Simplified Clnical Pulmonary Infection Score (CPIS) was used to measure VAP.Results: This study illustrates that there was no VAP incidence in the intervention group, and as much as 13.3% VAP in the control group. SACETT was more effective in preventing VAP than in standard ETT on day 4 (p = 0.001).Conclusion: SACETT is more effective in preventing VAP than standard ETT in the fourth day in patients with neurological, cardiovascular, urinary, digestive, and immune system disorders.

scholarly journals The effect of prenatal counseling on breastfeeding self-efficacy and frequency of breastfeeding problems in mothers with previous unsuccessful breastfeeding: A randomized controlled clinical trial

2020 ◽  
Author(s):  
fahimeh sehhatie shafaei ◽  
mojgan mirghafourvand ◽  
shiva havizari
Keyword(s):  
Self Efficacy ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Randomized Controlled Clinical Trial ◽  
Prenatal Counseling ◽  
Control Groups ◽  
Randomized Controlled ◽  
Breastfeeding Problems ◽  
And Control

Abstract Background: Breastfeeding is one of the most important interfering factors in infants’ health. Monitoring mothers’ performance and providing them with the feedback helps to increase their self-efficacy, interest in learning, and level of performance. The present research evaluates the effect of prenatal counseling on the breastfeeding self-efficacy and frequency of breastfeeding problems in mothers with previous unsuccessful breastfeeding.Methods: This randomized controlled clinical trial was conducted on 108 pregnant women with unsuccessful breastfeeding in Tabriz health centers during 2017-2018. The participants were randomly assigned to intervention and control groups. The intervention group had four prenatal counseling sessions and the controls only received routine care. Then, the mothers who gave birth to their children received a counseling session up to 4 months after the delivery. The Breastfeeding Self-Efficacy (BSES) questionnaire and the frequency of breast feeding problems checklist on the 15th day, and 2nd and 4th month were completed both by the intervention and control groups.Results: The mean (SD) of breastfeeding self-efficacy was 119.3 (10.5), 128.3 (8.3) and 133.8 (10.3) in the intervention group and 105.3 (16.1), 105.7 (19.7) and 109.4 (24.7) in the control group on the 15th day, 2nd and 4th month after the delivery, respectively. There was a significant difference in terms of breastfeeding self-efficacy between intervention and control group on the 15th day (p<0.001), and 2nd (p<0.001) and 4th (p<0.001) month after the delivery. The frequency of breastfeeding problems on the 15th (p=0.008), 2nd (p<0.001) and 4th (p<0.001) after the delivery was significantly different in most cases of the intervention group when compared to the controls.Conclusion: The results indicated that prenatal counseling can increase mothers’ breastfeeding self-efficacy and solves most breastfeeding problems during postpartum period.Trial registration: IRCT20100109003027N19

scholarly journals The Effect of Abdominal Massage on Enteral Complications in Geriatric Patients

2020 ◽  
Vol 6 ◽  
pp. 237796082096377
Author(s):  
Onur Çetinkaya ◽  
Özlem Ovayolu ◽  
Nimet Ovayolu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Geriatric Patients ◽  
Intervention Group ◽  
Control Group ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Quasi Experimental ◽  
Abdominal Massage ◽  
Positive Effect

Introduction and Purpose Geriatric patients, who are fed by nasogastric tube (NG), may suffer from complications. Therefore, this study was conducted to evaluate the effect of abdominal massage on Gastric residual volume (GRV), distension, vomiting, and defecation in geriatric patients, who were hospitalized in intensive care unit and fed by NG. Methods The quasi-experimental study was conducted in intensive care units. The researcher applied abdominal massage to patients in the intervention group (n = 30) twice a day for 15–20 minutes before feeding. The data of the study were collected by using a questionnaire and a parameter questionnaire. Results GRV decreased significantly in the intervention group and increased significantly in the control group ( p < 0.05). The frequency of defecation significantly increased in intervention group ( p < 0.05). It was found that there was no positive effect of abdominal massage on vomiting ( p > 0.05). Conclusion It was observed that while abdominal massage reduced high GRV and distension incidence, it increased the incidence of defecation.

scholarly journals Embolization with larger-caliber coils can increase packing density: Evidence from the pilot phase of a randomized trial

2016 ◽  
Vol 23 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Francis Cloutier ◽  
Naim Khoury ◽  
Jimmy Ghostine ◽  
Behzad Farzin ◽  
Marc Kotowski ◽  
...  
Keyword(s):  
Packing Density ◽  
Intervention Group ◽  
Cerebral Aneurysms ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Pilot Phase ◽  
Randomized Controlled ◽  
Undesirable Event ◽  
Initial Procedure ◽  
Endovascular Coil Embolization

Background and purpose Endovascular coil embolization of cerebral aneurysms is associated with suboptimal angiographic results in up to 20–30% of patients. Coil packing density has been used as an index of the success of the initial procedure. The trial sought to study the effects of using 15-caliber coils, as compared with 10-caliber coils, on packing density. Methods Does Embolization with Larger coils lead to better Treatment of Aneurysms (DELTA) is an investigator-initiated multicenter prospective, randomized, controlled clinical trial. Patients are randomized 1:1 to embolization with either 10-caliber coils exclusively (control group) or the highest safely achievable proportion of 15-caliber coils and 10-caliber coils if necessary (intervention group) in 4–12-mm aneurysms. The endpoint of the pilot phase of the trial was the capacity to increase packing density of the initial procedure, calculated using a mathematical transformation of the dimensions entered into the case report forms. Secondary outcomes included the total number of coils used per aneurysm, total fluoroscopy time, initial angiographic outcomes and any adverse or undesirable event. Results Seventy patients were recruited between June 2014 and November 2015. Compared with 10-caliber coils, the 15-caliber coil group had a higher median packing density (44% vs 24%, p = 0.017). Results of other outcome measures were similar for the two groups. Conclusion Coiling of small and medium aneurysms randomized to 15-caliber coils achieved higher packing densities compared with coiling using 10-caliber coils.

scholarly journals Effect of dental intervention on improvements in metabolic syndrome patients: a randomized controlled clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Midori Doke ◽  
Yuriko Komagamine ◽  
Manabu Kanazawa ◽  
Maiko Iwaki ◽  
Hiroyuki Suzuki ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Medical Information ◽  
Controlled Trial ◽  
Intervention Group ◽  
University Hospital ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Dental Intervention ◽  
Water Rate

Abstract Background Metabolic syndrome (MetS), caused by the accumulation of visceral fat, is considered a major cause of cardiovascular disease. This randomized controlled trial aimed to clarify the effect of dental intervention, including prosthodontics and/or periodontal treatment, combined with dietary and exercise guidance on MetS. Methods In total, 112 patients who met the Japanese waist circumference criteria of MetS were recruited. The intervention group (ITG) received dental intervention along with dietary and exercise guidance, while the control group (CTG) received dietary and exercise guidance alone. Three outcome measurements were obtained before intervention (BL), 1 month after intervention (1M), and 3 months after intervention (3M). Results Body water rate (p = 0.043) was significantly higher in ITG than in CTG at 1M. Simultaneously, fasting blood sugar level (p = 0.098) tended to be lower in ITG than in CTG. Lean mass (p = 0.037) and muscle mass (p = 0.035) were significantly higher and body weight (p = 0.044) significantly lower in ITG than in CTG at 3M. Body mass index (p = 0.052) tended to be lower in ITG than in CTG. Conclusions Dental intervention combined with lifestyle guidance may improve anthropometric status and reduce the risk of MetS. Trial registration University Hospital Medical Information Network Center Unique UMIN000022753. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000026176.

scholarly journals Objective Grading System Scores After the Use of a New Finishing Protocol

2020 ◽  
Vol 16 (1) ◽  
pp. 1-16
Author(s):  
Álvaro Carvajal Flórez ◽  
Óscar Zapata Noreña ◽  
Diana María Barbosa Liz ◽  
Patricia Plazas ◽  
Felipe Montoya Sepúlveda ◽  
...  
Keyword(s):  
Gold Standard ◽  
Odds Ratio ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Grading System ◽  
Randomized Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Objective Grading System

Objective: This non-randomized controlled clinical trial compared a new finishing protocol UDEA2 with the UDEA1 finishing protocol, according to the Objective Grading System (ogs).Methods: Forty-one patients treated in the postgraduate orthodontics clinic were included. Twenty patients served as intervention group (ig) with whom was used the UDEA2 protocol which includes dental positioners, and were compared to twenty-one patients that served as control group (cg) with whom was used the UDEA1 finishing protocol. An orthodontist (gold standard) determined the required movements with positioners used in the UDEA2 protocol. Eight ogs variables were measured by a calibrated clinician.Results: Both groups were comparable in gender, age and severity, but not in type of treatment applied. The total ogs for gc was 28.9±10.0, for ig at T1 (before the positioner) was 20.4±6.0 and the score for ig at T2 (after the positioner) was 19.2±6.0, with statistically significant differences (P≤0.05). The ogs score was principally increased for “alignment” in gc and ig-T1 groups. This variable decreased significantly in the ig-T2 group. There were no patients with more than 30 points in the ig-T2. The regression analysis showed an association (P=0.002) between the finishing protocol applied and the final ogs score. Possibility of belonging to the ig-T2 decreases as the ogs score increases (odds ratio [or] 0.83; 95% confidence interval [CI] 0.738, 0.933).Conclusions: The implementation of the UDEA2 finishing protocol, which includes an orthodontics student’s constant training, a Finishing Protocol Guide application, and a dental positioner in the finishing phase, showed an improvement in quality of orthodontic treatments.

scholarly journals The effects of multimedia education on anxiety and physiological status among patients with cerebral angiography: A randomized controlled clinical trial

2018 ◽  
Author(s):  
Leila Sayadi ◽  
Shokoh Varaei ◽  
Elham Faghihzadeh ◽  
Zahra Ahmadkhani
Keyword(s):  
Blood Pressure ◽  
Cerebral Angiography ◽  
State Anxiety ◽  
Intervention Group ◽  
Control Group ◽  
Physiological Status ◽  
Controlled Clinical Trial ◽  
Randomized Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Multimedia Education

Background &Aim: Cerebral angiography is a diagnostic procedure for cerebral disorders, particularly the disorders of cerebral blood vessels. However, as an invasive procedure, it can cause patients anxiety and physiological instability. This study aimed to evaluate the effects of multimedia education on anxiety and physiological status among patients with cerebral angiography. Methods & Materials: This randomized controlled clinical trial was conducted from October 2017 to January 2018 in the angiography unit of a university hospital in Tehran, Iran. Participants were 88 candidates for cerebral angiography who were randomly allocated either to an intervention (n = 44) or a control (n= 44) group. Patients in the intervention group were provided with at least thirty-minute multimedia education consisted of video-based education, verbal education, written materials (an educational booklet), and question and answer. Data on participants’ personal characteristics were collected before the intervention, while their state anxiety was assessed before multimedia education and after cerebral angiography via Spielberger State Anxiety Inventory. Moreover, participants’ physiological parameters were measured and documented in a data sheet before and every two hours after angiography up to their discharge from the angiography unit. The independent-sample t, Chi-square, and McNemar’s tests and the Generalized Estimation Equation were used for data analysis. Results: After the intervention, 95.5% of patients in the intervention group and 86.4% in the control group had low level of anxiety; however, the between-group difference was not statistically significant (P > 0.05). Moreover, anxiety level changed significantly neither in the intervention (P > 0.05) nor in the control (P > 0.05) group. In addition, after adjusting the effects of participants’ age, there were no significant between-group differences respecting the means of systolic blood pressure, the means of body temperature, peripheral oxygen saturation, and respiratory rate. However, the means of diastolic blood pressure and heart rate in the intervention group were significantly lower than the control group, irrespective of the effects of participants’ age. Conclusion: Multimedia education has no significant effects on state anxiety but has significant effects on diastolic blood pressure and heart rate among patients with cerebral angiography.

scholarly journals Smartphone application for celiac patients: assessing its effect on gastrointestinal symptoms in a randomized controlled clinical trial

2020 ◽  
Author(s):  
Zeinab Nikniaz ◽  
Masood Shirmohammadi ◽  
Elham Masserat ◽  
Zahra Akbari Namvar
Keyword(s):  
Clinical Trial ◽  
Intervention Group ◽  
Gastrointestinal Symptoms ◽  
Smartphone Application ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Trial Registry ◽  
Randomized Controlled Clinical Trial ◽  
Randomized Controlled ◽  
The Mean

Abstract Background: We aimed to study the effectiveness of a “celiac” smartphone application on gastrointestinal symptoms in celiac patients. Methods: In the present randomized controlled clinical trial, 60 celiac patients were randomly assigned to receive education through a smartphone application (n=30) or conventional clinical education (n=30). We assessed the gastrointestinal symptoms using the gastrointestinal symptom rating scale (GSRS) questionnaire at baseline and three months after interventions. The GSRS total score, celiac disease GSRS (CD-GSRS) score, abdominal pain, reflux, diarrhea, constipation, and indigestion scores were calculated. Results: Out of 60 randomized patients, 58 patients completed the study. In comparison to baseline, the mean score of GSRS total score (p=0.04), CD-GSRS score (p=0.001), and indigestion subscore (p<0.001) were significantly decreased in the intervention group. In the control group, compared to baseline, the mean scores of CD-GSRS score (p=0.03) and abdominal pain subscore (p=0.04) were significantly reduced; and the mean score of reflux (p=0.01) subscore was significantly increased. The results of the between-group comparisons showed that although the mean GSRS and CD-GSRS total scores were lower in the intervention group compared with the control group, the differences were not statistically significant. In terms of GSRS subscores, there was a significant difference between the two groups only in the mean score of indigestion (P=0.01).Conclusion: According to the results, smartphone application had a significantly positive effect on indigestion symptoms compared with routine clinic education. However, more large studies with longer duration of the follow-up period are needed to assure this approach Trial registration: The protocol of the study was registered in the Iranian registry of clinical trials (IRCT code: IRCT20170117032004N2). trial registry webpage: : https://www.irct.ir/user/trial/40187/view. Trial registry date: 2019.6.26

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