Naglaa Fathy Youssef

Objective: To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection (SCAI) on pain intensity and hematoma formation.

Methods: A quasi-experimental design was utilized. A convenient sample of 105 adult patients, who were admitted to one of the biggest teaching hospitals in Cairo and receiving SCAI, were recruited over a period of six months. Patients were randomly allocated into three groups: A Control group who received the routine hospital care (G1, = 35) and two intervention group who received cryotherapy for 5-min (G2: cryotherapy applied before SCAI,  = 35; G3: cryotherapy applied after SCAI,  = 35). Demographic and medical history data sheet, Pain Numeric Rating Scale and Hematoma Formation and Size Assessment Scale were used to collect the data.

Results: The pain intensity among the patients in the two intervention groups (G2:  = 1.0; G3:  = 0) was significantly lower than in the control group (G1,  = 3.0). No significant difference was found between G2 and G3( = 0.728). Applying cryotherapy after SCAI (G3) decreased the frequency of hematoma formation (48hrs = 31.4% & 72hrs = 28.5%) compared to applying it before injection (G2, 100%) or not applying it (G1, 100%). The size of hematoma in G3 was smaller than that in G2 ( < 0.01).

Conclusion: Applying cryotherapy significantly decreased pain intensity and hematoma occurrence/size. Applying cryotherapy after injection was more effective in preventing hematoma formation and decreasing its size than applying it before injection.

BACKGROUND: Studies discussing nurse educators' attitudes, knowledge/skills, practicing of evidence-based practice (EBP) and barriers encountered towards implementation is somewhat limited.

OBJECTIVE: The study aimed to identify the attitudes, perceived knowledge/skills, and implementation of evidence-based as perceived by nurse educators, in Egyptian and Jordanian universities, and to assess factors preventing them from adopting it in nursing program.

DESIGN/SETTING/RESPONDENTS/METHODS: A cross-sectional design was conducted including two groups from Egypt and Jordan. Two questionnaires: (i) The Evidence-Based Practice Questionnaire (EBPQ) and (ii) The Developing Evidence-Based Practice Questionnaire (DEBPQ) and a demographic data sheet were used. Data were analyzed using SPSS version 20 and descriptive and inferential statistics tabulated.

RESULTS: Majority of the respondents (85.5%) were females, <40 years old (62.1%), and from medical-surgical nursing departments (49.2%). The mean score of EBPQ was 4.96 ± standard deviation 0.91. Frequency of practicing EBP and attitudes toward EBP scores were similar between nurse educators in both countries (p > 0.05). However, the Jordanian staff had a remarkably higher perceived knowledge/skills of EBP than their Egyptian counterparts (Mean Rank = 79.98 & 57.63 respectively, at p = 0.004). There was a statistically significant positive, moderate correlation between attitudes, knowledge/skills and frequency of practicing EBP among nurse educators in both countries. The highest correlation observed for attitudes and frequency of practicing EBP was among Jordanian staff (r = 0.707, p < 0.000). Egyptian nurse educators had significantly higher perceived barriers to finding and reviewing evidence than their Jordanian counterparts (p = 0.000). However, both groups had similar perceived barriers related to changing practice and support from colleagues.

CONCLUSIONS: Egyptian and Jordanian nurse educators, equally, hold positive attitudes toward adopting EBP. However, they encounter many barriers to implement it.