Abstract
Aim.This study was conducted to investigate the level of nurses’ knowledge, attitude and practice about self-care education in people with heart failure.
Background.Heart failure is one of the most common chronic diseases and the leading cause of death in the world and also, a major cause of hospital readmission, especiallyin elderly patients. Self-care education is an essential componentof care for people with heart failure. Nurses are the first providers ofself-careeducation for patients and must have a thorough knowledge, a positive attitude and skillfull practice in the field of self-care education.
Method. In this descriptive-analytical study, 174 nurses with at least one year working experience in the CCU, post CCU and medical wards of ShahidRajaie Cardiovascular and Research Center, completed a four-part questionnaire including demographics information, and knowledge, attitude and practice about self-care education in people with heart failure. Data were analyzed using descriptive and inferential statistics in SPSS, version 22.
Findings. The majority of nurses (70.1 percent)  had an average knowledge score. The knowledge level of nurses were significantly related with level of education and working experience. Also, 67.8 percent of the participants had a good practice of self-care education about heart failure and their practice was significantly related with experiencing in-service education. More than 90 percent of nurses reported positive attitude towards self-care education about heart failure and their attitude was significantly related with level of education, in-service education and work schedule.
Conclusion. The knowledge of nurses was at average level. It is recommended to plan in-service education in order to promote nurses’ level of knowledge about self-care education about heart failure.

Abstract
Aim.The aim of this study was to compare clinical manifestations of ACS in middle-aged and elderly people who were hospitalized in ShahidRajai Cardiovascular Medical and Research Center in 2016 .
Background. ACS is one of the most important health challenges in the world. The most important diagnostic marker of ACS is the clinical symptoms, but the symptoms of the disease are different among middle-aged and elderly people.
Method. This study was a cross-sectional study. The sample consisted of 384 patients with ACS admitted to ShahidRajai Cardiovascular Medical and Research Center in 2016. Data collection tools included demographics form, a questionnaire for recording signs and symptoms of ACS and the pain questionnaire. Data were analyzed in SPSS 18.
Findings. The most common symptom was chest pain in both groups. Typical symptoms between the two groups showed no statistically significant difference. Of non-typical symptoms, hiccup was reported more in middle-age group than the elderly group (P=0.001). In terms of the location of the pain, left arm in the elderly was higher than the middle-aged group (P=0.001). The quality of pain in both groups was not significantly different.
Conclusion. Chest pain is the most common symptom in both middle-aged and elderly people. Among the non-typical symptoms, only hiccups in the middle-aged people are more common than the elderly people. Health care providers should pay more attention to the initial assessment.

Abstract
Aim. The purpose of this study was to determine the effect of supportive interventions on resiliency components and quality of life among family caregivers of people with advanced heart failure.
Background. Advanced heart failure is a costly, progressive and chronic disease that reduces resilience and quality of life among family caregivers.
Method. In a randomized clinical trial study that was conducted as a before-after design with control group and follow-up one month after intervention. One hundred family caregivers of people with advanced heart failure, admitted to Shahid Rajaie Cardiovascular and Medical Research Center, were randomly assigned into experimental and control group. The family support interventions package included participation in group training workshops for 6 sessions (2 sessions/week in three consecutive weeks) for the experimental group. Resilience Scale (Connor-Davidson) and Quality of Life (SF-36) questionnaire were used to collect the data, before, after and one month after intervention. Data were analyzed in statistical software SPSS 23 using statistical tests related to the distribution of variables including Chi-square, Fisher, Wilcoxon and Mann-Whitney test, and independent and paired t-test.
Findings. At baseline, the mean score of resilience and the overall score of quality of life showed no statistically significant difference between the groups. After intervention, there was a statistically significant difference in terms of the mean score of resilience between the experimental (64.06±11) and control (48.34±16.23) group (P<0.05). Also, the overall score of quality of life after intervention was statistically significant between the experimental (70±12.91) and control (50.82±17.73) group (P<0.05). The results of paired t-test showed that one month after the end of the intervention, in the experimental group, the mean score of resilience (63.08 ± 10.15) and the overall score of quality of life (69.82±12.70) remained constant, indicating the sustainability of the effect of interventions after one month (P>0.05).
Conclusion. As part of a holistic program, the results of this study can be a guide to setting up a centralized unit for the education and support of family caregivers of people with chronic heart disease, a unit in which, in addition to social support and mental health education, their needs in terms of knowledge of the disease and participation in the care of their patients would be met.

Abstract
Aim. The purpose of this study was to examine the effect of Zero-balance (Z-Buf) ultrafiltration on arterial blood gases in patients undergoing coronary artery bypass graft surgery.
Background. Cardiopulmonary bypass can cause complications such as systemic inflammatory response syndrome, ischemic reperfusion injury, decreased cardiac output, and other related complications.
Method. This study was a randomized clinical trial study with control group. Seventy six patients undergoing coronary artery bypass grafting were selected through consecutive sampling method from early January 2016 to the end of June 2017. To allocate the participants into groups, randomized blocking method was used. Patients in the experimental group were connected to the cardiopulmonary bypass system and Zero-balance (Z-Buf) ultrafiltration. Arterial blood gases including BE, Pao2, Pco2, Tco2, PH, Lactate, and O2Sat were measured in the preoperative time, every half hour during the operation, immediately after the operation and 6 hours after transferring the patient to intensive care unit. The data were analyzed by descriptive and inferential statistics in SPSS Version 22.
Findings. The results showed that the changes in PCO2 in both groups were not statistically significant, but the changes in other arterial blood gas parameters (BE, Pao2, Tco2, PH, Lactate, O2Sat) were statistically significant in two groups (P<0.05). There were more changes in arterial blood gases in the control than the experimental group.
Conclusion. The use of Zero-balance ultrafiltration reduces changes in arterial blood gas parameters in patients with undergoing coronary artery bypass graft surgery. The use of this method by heart surgeons and perfusionists can reduces the incidence of clinical complications in these patients.

Abstract
Aim. This Study aimed to examine the effect of social networking education on blood glucose control and post-surgical infections after open heart surgery in diabetic patients.
Background. Cardiovascular surgery is one of the most common surgeries that is performed with the aim of increasing survival and improving the quality of life in diabetic patients.
Method. This randomized clinical trial study was conducted on 120 diabetic patients (age range 18-60 years) who underwent open heart surgery at Shahid Rajaei Cardiovascular Research and Research Center. The participants were randomly divided into experimental (n=60) and control group (n=60). In the experimental group, posts were delivered to patients with educational content (such as nutrition education, blood sugar self-monitoring, and ...) on a daily basis for three months on the WhatsApp social network. Data were collected by a checklist consisting of three parts: demographic characteristics, fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c) of patients before and 3 months after the intervention.
Findings. In both experimental and control group, 55 percent were male and 45percent were female. The percent of patients with postoperative wound infection in the experimental and control groups was 5.0 and 3.3, respectively. After intervention, in the experimental group, the FBS and Hb1Ac median was significantly reduced compared to before the intervention (p<0.001). The levels of FBS and Hb1Ac before and after the intervention did not differ significantly between the experimental and control group.
Conclusion. There was no different between groups in terms of blood sugar control and wound infections after open heart surgery. Due to the easy access, lack of time and space limitations of using social networks, further studies with longer follow-up are recommended.