Cardiovascular Nursing Journal

Assessment of death notification to the families of deceased patients in Intensive Care Units of a specialized cardiovascular medical center

Shiva Khaleghparast

Abstract
Aim .The aim of this study was to assess the current status of death notification by healthcare staff to the families of deceased patients in the intensive care units of a specialized cardiovascular medical center in 2020.
Background. Delivering bad news, particularly death notification, is one of the most important and challenging responsibilities of healthcare providers in intensive care units (ICUs). This process has profound psychological and emotional impacts, not only on the patient, but also on their families. This study was conducted to evaluate the performance of the healthcare staff in delivering death news, identify existing strengths and weaknesses, and provide potential solutions for improving this process.
Method. This descriptive cross-sectional study used the SPIKES questionnaire to assess the communication skills of the healthcare staff in delivering death news. A total of 121 healthcare staff members from the intensive care units of the specialized cardiovascular medical center participated in the study, selected via census sampling. Data were analyzed using SPSS version 24, and a significance level of 0.05 was considered.
Findings. Of the 232 death notifications, 32.3 percent were delivered in person, and 67.7 percent were delivered by phone. The mean score obtained from the SPIKES questionnaire was 3.70±1.56, indicating an average performance in delivering death news. This result suggests that the performance of the healthcare staff in this regard is reasonably acceptable but still has room for improvement. The study also found that, in this center, the majority of death notifications were delivered by phone, which contradicts global standards that emphasize delivering death news in a private and in-person setting.
Conclusion. This study showed that healthcare staff in intensive care units need continuous training in communication skills and methods for delivering bad news to patients' families. Additionally, the results indicate the necessity of developing standardized protocols for death notification in healthcare settings. It is recommended that senior management pay special attention to this matter and develop precise protocols to improve the quality of this process and prevent the psychological harm caused by delivering death news to families.

Artificial intelligence for monitoring medication use and therapeutic behaviors in patients with cardiovascular disease; the role of nurses: A systematic review

Samaneh Shahidifar

Abstract
Aim. This systematic review aimed to investigate the role of nurses in using artificial intelligence to monitor medication use and therapeutic behaviors in patients with cardiovascular disease.
Background. With the increasing complexity of cardiac care and cardiac patient medication regimens, the use of artificial intelligence as a clinical decision support tool, especially in the nursing profession, has become increasingly important. This technology can play an effective role in monitoring cardiac medication use, reducing medication errors, and improving patient treatment behaviors.
Method. This study was conducted as a systematic review. Electronic databases including CINAHL, Medline, Google Scholar, Web of Science, Scopus, and SID were searched for relevant articles published between 2020 and 2025. Studies meeting predefined inclusion and exclusion criteria were selected, and their quality was assessed using the Joanna Briggs Institute appraisal tools. A total of 17 articles were included in the final analysis.
Findings. The results suggest that AI-based systems, including machine learning algorithms, neural networks, and risk prediction models, can help improve cardiac safety, monitor vital signs, and increase patient compliance with prescribed treatments. However, challenges were identified, such as nurses' resistance to technology, ethical concerns, threats to professional identity, lack of infrastructure, and issues related to data security and privacy.
Conclusion. Artificial intelligence demonstrates substantial potential to enhance nursing care quality, patient safety, and medication monitoring. Nevertheless, successful integration requires a human-centered approach, targeted education for nurses, organizational support, and preservation of clinical judgment.

Distance education in nursing for patients with Acute Coronary Syndrome: Methods, Outcomes, and Challenges

Rasool Eslami Akbar

Abstract
Aim. The aim of this study was to review and analyze the existing evidence regarding the methods, outcomes, and challenges of distance education in nursing for patients with Acute Coronary Syndrome (ACS).
Background. ACS is one of the leading causes of mortality and disability worldwide, and patients face challenges in treatment adherence, lifestyle modification, and psychological management of the disease after discharge. In recent years, nurse-led interventions, particularly utilizing telenursing and communication technologies, have been proposed as novel strategies to improve post-discharge care.
Method. This study was conducted as a systematic review of published research examining nurse-led distance education interventions in patients with ACS. For data collection, the data bases and search engines including PubMed, Scopus, ISI, Google Scholar, and the Iranian Scientific Information Database were searched out over the last ten years (2011 to 2026). The search strategy combined keywords including Distance Education, Nursing Care, Coronary Syndrome, Telenursing, Patient Education, Cardiac Care, Telehealth, and their Persian equivalents. Included studies were randomized controlled trials, quasi-experimental, observational, and qualitative studies. Data were extracted focusing on the type of intervention, follow-up duration, outcomes, and challenges, and were synthesized using thematic analysis. Among 35 identified articles, after removing duplicates (n=5) and irrelevant articles (n=15) through screening of abstracts, 15 articles were selected for final eligibility assessment, and ultimately 11 articles were included in the study. The quality of evidence was assessed using the PRISMA checklist.
Findings. Nurse-led distance education interventions, according to the objectives of the present study, could be categorized into themes including improvement of clinical outcomes and lifestyle modification, enhancement of self-care and self-efficacy, improvement of patient experience and satisfaction, diverse telenursing methods, and executive and procedural barriers and challenges. Furthermore, telenursing education was associated with reductions in cardiovascular risk factors, increased physical activity, improved medication adherence, enhanced self-efficacy, improved quality of life, and increased happiness in patients with ACS.
Conclusion. Telenursing education is considered an effective and feasible approach for improving care and outcomes in patients with ACS. It can lead to improved clinical outcomes and lifestyle modification, while enhancing patient self-care and self-efficacy and increasing their satisfaction. Developing structured and sustainable programs and conducting future research with long-term follow-ups can help strengthen the evidence, effectively integrate these interventions into clinical care, and address executive barriers and challenges.

Governance of Iran's infertility control policies, with focus on cardiovascular risk care in infertile women

Bahareh Morshed-Behbahani

Abstract

Aim. This study aimed to explain the practice of governance in Iran's infertility control policies, with a specific focus on cardiovascular risk care for infertile women, drawing on the TAPIC analytical framework (Transparency, Accountability, Participation, Integrity, and policy Capacity).
Background. As a reproductive health issue with major demographic dimensions, infertility has gained a prominent place on Iran's health-sector agenda over the past two decades, coinciding with a shift in national population policy toward raising fertility rates. Alongside this policy attention, growing evidence indicates that infertility itself, particularly ovulatory-disorder infertility such as polycystic ovary syndrome (PCOS), as well as assisted reproductive treatments, is associated with an increased risk of cardiovascular disease (CVD) later in life, a risk that has received limited attention within Iran's infertility control policies, which have mainly focused on expanding access and financial coverage for treatment.
Method. This study employed a document-based, directed qualitative content analysis of the international and national (Persian-language) peer-reviewed literature. Findings were categorized and analyzed across the five TAPIC domains. The study relies entirely on the review and analysis of existing texts and documents, without primary data collection or interviews.
Findings. The evidence indicates that Iran's infertility control policies face governance challenges across all five TAPIC domains regarding cardiovascular risk coverage for infertile women: limited transparency in recording infertile women's cardiovascular history within health information systems; unclear accountability between infertility and cardiology services; limited participation of cardiologists in the formulation of infertility guidelines; weak integration between cardiometabolic screening and infertility treatment pathways; and limited policy and infrastructural capacity for systematic cardiovascular risk screening in infertility clinics. Comparison with selected country experiences (including the UK's regulatory system and international PCOS guidelines) shows that integrating cardiovascular screening into infertility care pathways remains incomplete even in advanced health systems.
Conclusion. Strengthening the governance of Iran's infertility control policies requires the formal integration of cardiovascular screening and care into infertility service pathways, clearly defined accountability between infertility and cardiology services, the engagement of cardiologists in policymaking, and investment in workforce and information-system capacity-building.