Abstract
Aim. The aim of this study was to analyze the concept of heart risk perception from healthcare staff perspective using hybrid method of concept analysis.
Background. In the discussion of behavior, awareness of risk factors for cardiovascular disease is very important in helping individuals to make informed decisions about continuing certain behaviors that increase the risk of the disease, but what matters more is the perception of a person at risk of a disease that affects his or her health functions.
Method. Hybrid model of concept analysis was used to clarify the meaning of perception of risk of heart disease. Three phases of a hybrid concept analysis include theoretical, fieldwork, and final analysis. In theoretical phase, different databases including PubMed, CINAHL, Science Direct, Google Scholar, SID and Magiran were searched for related articles published from 1990 to 2018). The search keywords were perception of risk; heart disease in titles and abstracts of the papers. In the fieldwork phase, semi-structured in -depth interviews were conducted with 18 nurses who were selected by purposive sampling. In next step, by combining the two previous stages the final analysis was performed.
Findings. The combination of theoretical and fieldwork findings resulted in definition of heart risk perception from healthcare staff perspective: “Understanding the risk of heart disease is a form of acquiring awareness of the risk of heart disease that is influenced by beliefs, values, culture and attitudes of individuals, and it stimulates learning and changing self-care behaviors for efficacy in promoting heart health and avoiding risk factors.”
Conclusion. The results of this study will help to clarify the concept of perception of risk of heart disease among healthcare system staff. This clarification may lead to offering comprehensive view and better understanding for use in the research and practice.

Abstract
Aim. The present descriptive study was conducted with the aim of evaluating the knowledge and skill of pre-hospital emergency technicians in Neyshabour, Iran, in the management of patients with acute coronary syndrome.
Background. Pre-hospital emergency personnel who have sufficient knowledge and skill to diagnose, giving care and transfer of patients can increase the chance of survival and decrease the possibility of acute and chronic complications of the disease.
Method. In this descriptive cross-sectional study, 126 operational personnel working in the emergency medical center of Neyshabour City, Iran, were recruited by census sampling and participated in the study during a one year period in 2021. The data was collected using a researcher-made questionnaire including demographic information, knowledge level questionnaire, and a pre-hospital emergency personnel skill checklist measuring the management of patients with acute coronary syndrome. The data were analyzed in SPSS version 19 through descriptive statistics.
Findings. The overall knowledge score of the majority of participants in the management of patients with acute coronary syndrome was at a good level (58.7 percent); the highest knowledge score was reported in the interpretation of electrocardiography and the lowest knowledge score was in diagnosing the symptoms of acute coronary syndrome. Finally, the overall skill score of the majority of pre-hospital emergency technicians was at a good level (79.4 percent); the highest skill score was reported in the principles of cardiopulmonary resuscitation and the lowest skill score was in performing cardiac monitoring and detecting arrhythmias.
Conclusion. The majority of pre-hospital emergency technicians had an acceptable level of knowledge and skill in the field of managing patients with acute coronary syndrome, but some skills were far from the desired level. Therefore, due to the importance of strengthening the knowledge and skills of pre-hospital emergency personnel, as the first members of the emergency team dealing with cardiac patients, in the management of patients with acute coronary syndrome, regular training and awareness of updated guidelines are recommended.