BackgroundOral mucositis is one of the irritating side effects of chemotherapy in patients undergoing bone marrow transplantation. However, up until now, the common methods of oral mucositis therapy have failed to show significant effects.ObjectivesThe aim of this study was to investigate the effects of local cryotherapy on the intensity of chemotherapy-induced oral mucositis in autologous bone marrow transplantation patients.Patients and MethodsIn this single, blinded, randomized clinical trial, 29 patients undergoing stem cell transplantation in Iran were selected by convenience sampling, and randomly allocated to control (n = 13) and intervention groups (n = 16). In the intervention group, cryotherapy was applied, while the control group received a normal saline mouthwash. The severity of the mucositis and neutrophil rate were investigated in five periods, based on the world health organization (WHO) scales. The data were analyzed using descriptive statistics, the Mann-Whitney test, repeated measures analysis of variance (ANOVA), and linear regression.ResultsIn both groups, the mucositis reached its peak intensity on the 7th day, and the least intensity was obtained on the 21st day. The neutrophil rate reached the minimum value on the 7th day, then increased up to the 21st day. The two groups showed no significant differences between the mucositis severity on the 14th and 21st days (P = 0.164), while the severity of the mucositis in the cryotherapy group was significantly less than that in the saline mouthwash group (1.81 < 2.54 and 0.13 < 0.92, respectively) on the 7th and 14th days (P < 0.05). There was no significant difference in the neutrophil rate between the groups.ConclusionsThe results showed that cryotherapy is more effective than the saline mouthwash in reducing the severity of mucositis. This method is recommended for the prevention of mucositis in bone marrow transplantation.

Reducing nurses' autonomy can impair their decision-making and ability for appropriate interventions. Lowered independence hinders ethical reasoning, which may lead to moral distress. This descriptive correlation study investigates the relationship between professional independence and moral distress in 173 nurses working in emergency departments in Tabriz, Iran. Data were collected using questionnaires designed to assess professional autonomy and moral distress and analysed using descriptive and inferential statistics via the SPSS 13 software. The level of professional autonomy among emergency nurses was low (83.2±16.9), and moral distress, moderate (7.43±3.52). A statistically significant negative relationship was reported between professional independence and the frequency of moral distress (p=0.018). Bivariate analysis related professional autonomy with the frequency and intensity of moral distress. Multiple regression analysis showed that age significantly predicted moral distress (frequency, intensity, and total scores). Lack of autonomy hinders nurses from functioning effectively and efficiently in practice and even can lead to moral distress. Increasing professional independence and the use of experienced nurses as mentors in emergency settings to support younger nurses can help with the reduction of moral distress.

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A brief self-care education program was not sufficient to significantly improve the quality of life patients with gastric cancer after gastrectomy.