Bahonar Elahe, Najafi Ghezeljeh Tahereh, Haghani Hamid
Department of Critical Care Nursing (Ms Bahonar and Dr Najafi Ghezeljeh) and Statistic and Mathematics Department (Dr Haghani), Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran; and School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (Dr Najafi Ghezeljeh).
Holist Nurs Pract. 2019 May/Jun;33(3):177-186. doi: 10.1097/HNP.0000000000000326.
Consciousness disturbances are the most common posttraumatic complications. The purpose of this study was to compare the single and combined effects of nature sounds and foot sole reflexology massage on level of consciousness in traumatic comatose patients. This randomized controlled clinical trial was conducted in 2 teaching hospitals in an urban area of Iran. Samples were 120 traumatic comatose patients who were randomly assigned into control, nature sounds, foot reflexology massage, and nature sounds plus foot sole reflexology massage groups. Patients in all groups received routine care. Interventions were performed twice a day for 2 weeks, each time for 30 minutes. The patients' level of consciousness was assessed using the Glasgow Coma Scale before, 1 week, and 2 weeks after the intervention. The groups had no significant differences in the mean scores of the consciousness level before, 1 week after, and the last day of the intervention. Also, there was a significant difference in the number of patients who regained full consciousness (P = .001) in the intervention groups compared with the control group. Significant differences in the number of days of consciousness were reported in at least one of the groups compared with other groups (P = .001). This difference was significant in the control group compared with the foot reflexology massage group (P = .032), as well as the nature sounds plus foot sole reflexology massage group (P = .001). Single or combined interventions can increase the level of consciousness in comatose patients and reduce the duration of coma.
意识障碍是最常见的创伤后并发症。本研究的目的是比较自然声音和足底反射疗法按摩对创伤性昏迷患者意识水平的单一和联合作用。这项随机对照临床试验在伊朗一个城市地区的两家教学医院进行。样本为120名创伤性昏迷患者，他们被随机分为对照组、自然声音组、足部反射疗法按摩组和自然声音加足底反射疗法按摩组。所有组的患者均接受常规护理。干预措施每天进行两次，持续2周，每次30分钟。在干预前、干预1周后和干预2周后，使用格拉斯哥昏迷量表评估患者的意识水平。在干预前、干预1周后和干预最后一天，各组意识水平的平均得分无显著差异。此外，与对照组相比，干预组中恢复完全意识的患者数量存在显著差异（P = 0.001）。与其他组相比，至少有一组报告的意识天数存在显著差异（P = 0.001）。与足部反射疗法按摩组（P = 0.032）以及自然声音加足底反射疗法按摩组（P = 0.001）相比，对照组的这种差异具有显著性。单一或联合干预可提高昏迷患者的意识水平并缩短昏迷持续时间。
