Background & Aim: This trial aimed to compare the pain relief and side effects of Oral Acetaminophen (OA) and Intravenous Acetaminophen (IVA) after CABG surgery. Methods & Materials: This parallel-group, triple-blinded, randomized trial was conducted on 113 CABG patients from September 2017 through February 2018.  The samples were selected through blocked randomization and allocated into two groups using computer-generated. The participants administered 1gr oral (OA group, n=57) or intravenous Acetaminophen (IVA group, n=56) every 6h for the first 24h following surgery; also, pain controlled in both group with Morphine multimodal analgesia strategy. Pain intensity measurement by VAS was followed after extubating the endotracheal tube at the 0, 1, 6, 12, 18 and 24 hours during the rest and deep breathing. The Morphine consumption and the incidence of nausea and vomiting in the first 24h were assessed. Data were analyzed using SPSS software and Chi-square, t-test, mixed ANOVA and ANCOVA test. Results: The pain score in the IVA group was found to be statistically significantly lower than the OA group at rest (P<0.001) and during deep breathing (P<0.001) in the first 24h. There was no statistically significant difference between groups regarding the cumulative Morphine consumption (P=0.056). The use of IVA was associated with a reduction in frequencies of nausea and vomiting incidents (P=0.029). Conclusion: Administration of IVA for the management of postoperative pain in CABG patients significantly reduced pain score and incidence of nausea and vomiting compared to OA. Any reduction in cumulative Morphine consumption did not accompany the lower pain.

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IntroductionHealthcare workers are a crucial workforce; from a moral perspective, understanding their concerns and how to support them is crucial and makes it possible for health services to keep functioning. This study aimed to develop and validate Health Care Workers’ Concerns in Infectious Outbreaks Scale (HCWCIOS).MethodsThis exploratory sequential mix-method study was employed to design and validate the HCWCIOS. The initial tool was designed after searching similar studies and performing a qualitative phase under the semi-structured approach. Both qualitative and quantitative methods were used to evaluate the face and content validity. The content validity ratio, content validity index, and item-level content validity index were also calculated. Exploratory factor analysis was employed to evaluate the construct validity. Using a convenient sampling method, 354 Iranian healthcare workers participated in the study. Computing Cronbach’s alpha coefficient estimated the internal consistency for HCWCIOS and its subscales. Furthermore assessed was test–retest reliability.ResultsThe preliminary scale was designed with 57 items. By eliminating nine items in the content validity phase and 12 items during factor analysis, the final 36-item scale was developed on six factors: inadequate preparedness, lack of knowledge, risk perception, affected social relations, work pressure, and absenteeism. These six factors accounted for 46.507% of the total variance. The whole scale’s Cronbach’s alpha coefficient was 0.912, and the intra-class correlation coefficient was 0.88.ConclusionA 36-item HCWCIOS has good psychometric properties and is suitable for measuring healthcare workers’ concerns during a pandemic.

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