Abstract
Aim. The present study was conducted to examine the effect of an empowerment program on the life satisfaction of patients with coronary artery disease.
Background. Because of the chronic and progressive nature of coronary artery disease, patients suffer frequent problems and relapses. Heart disease is considered as one of the debilitating diseases, and as such adversely affects the patient's self-care, quality of life, and health status.
Method. In this randomized clinical trial, 84 people with coronary artery disease, admitted to post-CCU wards in Tehran's Center for Heart diseases, were recruited in 2017. The study subjects were selected based on inclusion criteria. After explaining the study objectives and obtaining written signed consents, patients were assigned to experimental and control groups by blocking random allocation. Both groups completed questionnaires for demographic data and disease history, and Life Engagement Test. The Magic Empowerment Program was performed for experimental group as three workshop sessions for three consecutive days. Intervention continued after patients' discharge from the hospital through phone calls once a week for eight weeks. The Life Engagement Test was completed by the researcher for both groups, data were analyzed in SPSS-16 using descriptive and inferential statistics.
Findings. The results showed no statistically significant difference between groups in terms of demographic variables and disease history. Before intervention, there was no statistically significant difference between the mean scores of life satisfaction of experimental and control group and the two groups were homogeneous. After intervention, a statistically significant difference was observed between the groups in mean score of Life Engagement (P≤0.0001). The mean score of life satisfaction in experimental group, before and after the intervention was statistically significant (P≤0.0001), while in the control group there was no statistically significant difference.
Conclusion. The empowerment program increased life satisfaction of patients with coronary artery disease. Nurses can benefit from the empowerment program to improve life satisfaction, which is one of the dimensions of psychosocial health, in these patients.

Abstract
Aim. The aim of this study was to determine the moderating role of affective temperament in the relationship between biomarkers (troponin, white blood cell count, and neutrophil to lymphocyte ratio) and the severity of coronary artery disease.
Background. Coronary artery disease is the leading cause of death among adults worldwide and is considered as an inflammatory disease. Recent studies, in addition to biological factors, have focused on the role of psychological factors in the incidence and severity of this disease.
Method. In this study, 200 patients (145 males, 55 females) with coronary artery disease admitted to Shahid Rajaei Hospital in Tehran in 2018-2019 were selected by continuous sampling. Participants were asked to complete the positive and negative affectivity scale (Besharat, 2014). Also, the number of biomarkers was assessed through blood tests and the number of involved vessels was assessed through angiography and diagnosis by a specialist physician.
Findings. The results of hierarchical multiple regression showed that in the first step, 62 percent of the variance of coronary artery disease was predicted by biomarkers, and by entering the interaction between predictor variables (severity of coronary artery disease) and moderating variables (positive affectivity and negative affectivity), explanation of variance of the coronary artery disease increased by 9 percent and reached to 71 percent.
Conclusion. Based on the findings of the study, affective temperament affects the relationship between biomarkers and the severity of coronary artery disease, and therefore, as a psychological factor, could plays an important role in preventing coronary artery disease and decrease the number of deaths and the annual cost of this disease.

Abstract
Aim. This study aimed to examine the effect of education about anti-platelet drugs consumption through telephone follow-up on medication adherence in patients with coronary angioplasty.
Background. Regarding the necessity of proper use of antiplatelet drugs after coronary angioplasty, adherence to treatment is of great importance, and it is considered as one of the major concerns.
Method. This quasi-experimental study was conducted on 392 patients with percutaneous coronary intervention. The patients were divided into two experimental (telephone fallow-up) and control (without telephone fallow-up) group for one year. Adherence to treatment was assessed using the Morisky Medication Adherence Scale before and after percutaneous coronary intervention. Data were analyzed using t-test, chi-square and linear regression model in SPSS software.
Findings. The mean age of patients was 61.71±10.28 years in the experimental group and 60.72±11.14 years in the control group. Changes in the mean score of medication adherence was 53.09±1.37 in the experimental group and 18.09±1.30 in the control group, indicating a statistically significant increase in medication adherence in the experimental group compared with the control group (P=0.001). Non-use of anticoagulants in the experimental group increased until the end of the sixth month of telephone follow-up and then, decreased until the end of the twelfth month of follow-up.
Conclusion. Since changes in the mean score of adherence to medication in the experimental and control groups was significant, it is recommended that follow-up interventions in patients be continued continuously for at least one year.

Abstract
Aim. This study aimed to address whether spiritual intelligence was correlated with self-efficacy in patients with acute coronary syndrome (ACS).
Background. Patients experiencing acute coronary syndrome (ACS) are often required to enhance their empowerment skills to manage their signs and symptoms in an effective manner. In this sense, self-efficacy has been considered as a useful factor to develop self-care practices and minimize the risks of coronary artery disease (CAD).
Method. Using a descriptive-correlational research design, a total number of 136 patients admitted to cardiac care units (CCUs) of the hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran, were selected through the convenience sampling. The data were further collected via the demographic characteristics information questionnaire, King’s Spiritual Intelligence Self-Report Inventory (SISRI, 2008), and the Cardiac Self-Efficacy Questionnaire (CSEQ) developed by Sullivan et al. (1998), and then analyzed using the SPSS version 22.
Findings. Most patients in this study (61.8 percent) were male, married (69.1 percent) with a mean age of 58.85. Moreover, the score of spiritual intelligence was 47.18. The patients received a mean score of 13.72 in the “critical existential thinking” subscale and a mean score of 10.19 in the “personal meaning production” subscale. The mean scores for the “transcendental awareness” and “conscious state expansion” subscales were also 9.70 and 9.47, respectively (p=0.01).
Conclusion. It was concluded that higher levels of spiritual intelligence could improve self-efficacy in patients affected with ACS; therefore, adopting strategies to boost this type of intelligence could augment resilience in such individuals.

Abstract
Aim. The aim of this study was to evaluate the effect of stress-based mindfulness therapy on psychological well-being and Covid-19 anxiety in people with cardiovascular disease in Karaj, Iran.
Background. During the Covid-19 pandemic, people with cardiovascular disease have had many problems in the field of psychological health including anxiety. One of the effective modalities to manage anxiety is mindfulness therapy that potentially reduces stress and may affects psychological well-being.
Method. This was a quasi-experimental pretest-posttest study with a control group. The statistical population of the study included all women with cardiovascular disease in Karaj, Iran. Thirty people of the target population were selected by convenience sampling and randomly assigned to experimental and control group (15 people in each group). The research instruments included psychological well-being questionnaire (1989) and Corona anxiety questionnaire. Data were analyzed using descriptive and inferential statistics (multivariate and univariate analysis of covariance) in SPSS software version 19.
Findings The results showed the effect of stress-based mindfulness on psychological well-being and Corona anxiety in women with cardiovascular disease (p≤0.0001). The intervention explained 43% of the variance of psychological well-being and 24% of the Corona anxiety.
Conclusion. Considering the effectiveness of stress-based mindfulness therapy on psychological well-being and Corona anxiety in people with cardiovascular disease, it is suggested to apply this treatment method in psychological clinics and health centers to improve mental health.

Abstract
Aim. The aim of this study was to compare the effect of integrative behavioral couple therapy, narrative couple therapy, and couple schema therapy on affective capital and depression among people with coronary artery disease.
Background. Coronary artery disease is one of the heart diseases that can cause problems for couples.
Method. This was a semi-experimental study with a pretest and posttest design and control group. The statistical population consisted of people with coronary artery disease and their spouses out of which 64 couples were selected by purposive sampling method and randomly assigned to three experimental groups and a control group (16 couples in each group). Affective Capital Questionnaire and Depression Inventory of Beck was used to assess dependent variables in two stages. The three intervention groups were each treated for 8 sessions of 90 minutes and the control group did not receive any treatment. The data were analyzed in SPSS by descriptive and inferential statistics.
Findings. In terms of affective capital, there was a statistically significant difference of integrative behavioral couple therapy, narrative couple therapy and couple schema therapy with the control group (p­≤0.001), and of integrative behavioral couple therapy with narrative couple therapy and couple schema therapy (p­≤0.001). For depression, there was a statistically significant difference of the three intervention groups with the control group, and of integrated behavioral couple therapy and couple schema therapy with couple narrative therapy (p<0.05).
Conclusion. According to the results, integrative behavioral couple therapy, couple schema therapy and narrative couple therapy are effective in increasing affective capital and reducing depression in people with coronary artery disease and their spouses. It is recommended that these three interventions be used for these patients and their spouses in cardiovascular disease centers.
 

Abstract
Aim. The aim of this study was to review the cardiovascular disorders and complications caused by COVID-19.
Background. Coronavirus (COVID-19) disease is a viral disease caused by the SARS-CoV-2 virus. The virus was first discovered in Wuhan, China, and was declared a global pandemic due to its widespread prevalence. So far, about 500 million cases of and 6 million deaths from the disease have been reported worldwide. SARS-CoV-2 mainly causes respiratory problems, and fever, cough, shortness of breath, myalgia, fatigue and diarrhea are common symptoms of the disease. COVID-19 also causes cardiovascular disorders, which due to the importance of the impact of these disorders on the health of people in the community, in this article, studies and research conducted in this field were reviewed.
Method. The keywords “Covid-19”, “Coronavirus”, and “Cardiovascular complication” were searched out in databases, Web of Science, Scopus, PubMed, and Google Scholar. Out of 84 articles that were found the more relevant ones to the research topic were selected. After reviewing the studies thoroughly, 33 papers that were in line with the purpose of the study were selected and reviewed.
Findings. Studies and findings have shown that COVID-19 can cause cardiovascular complications such as cardiac arrhythmias, acute coronary syndrome, acute myocardial injury, myocarditis and heart failure.
Conclusion. Given the prevalence of COVID-19 and its high prevalence worldwide, it is important to be familiar with the cardiovascular disorders caused by the disease and how to treat and manage these disorders.

Abstract
Aim. The present study aimed to compare the effect of schema therapy and dialectical behavior therapy on lifestyle of women with coronary artery heart disease.
Background. Given that an unhealthy lifestyle is one of the main determinants of early onset of coronary heart disease in adulthood and its resulting mortality, the need for therapeutic interventions in this group of patients seems necessary.  
Method. This experimental study (pre-test-post-test with control group and follow-up) was conducted on women with coronary heart disease in Tehran in 2019-2020. A total of 45 female patients were selected by available sampling method and randomly allocated to two experimental group and one control group (15 people in each group). Experimental and control groups were assessed during the pre-test, post-test and one-month follow-up stages by Lali et al. (2012) lifestyle questionnaire. Eight sessions of group schema therapy (for one experimental group) and eight sessions of group dialectical behavior therapy (for another experimental group) were held (two sessions per week for 4 weeks). The data were analyzed using repeated measures analysis of variance in SPSS V.23.
Findings. Both interventions were effective in promoting lifestyle in women with coronary heart disease (p≤0.0001). Also, group dialectical behavior therapy had a greater effect on lifestyle promotion in women with coronary heart disease compared with group schema therapy (p≤0.0001).
Conclusion. Training of the use of group dialectical behavior therapy is recommended as an effective intervention method for improving lifestyle of women with coronary heart disease.

Abstract
Aim. The aim of this study was to examine the effect of cognitive-behavioral therapy on depression, anxiety, and stress in patients after coronary artery bypass graft surgery.
Background. Coronary artery bypass graft surgery, like other surgeries, is stressful for the patient, and depression, anxiety, and stress are common important disorders in these patients. In this regard, one of the effective psychotherapy methods to reduce negative psychological factors and prevent recurrence of the disease is cognitive-behavioral therapy.
Method. The design of the present study was quasi-experimental with a pretest-posttest design with a control group. The statistical population of the study included all patients after coronary artery bypass graft surgery in selected AJA hospital in Tehran, Iran. Based on convenience sampling, 30 people were selected and randomly allocated to experimental (n=15) and control (n=15) group. They responded to the Depression, Anxiety and Stress Questionnaire (DASS-21) and underwent 15 sessions of psychotherapy. The experimental and control group were homogeneous in terms of age, education, as well as duration of hospital stay and absence of other chronic diseases. The univariate analysis of covariance was performed using SPSS-23.
Findings. The results showed that depression, anxiety and stress of the experimental group significantly reduced in the post-test compared to those of control group.
Conclusion. In addition to medical interventions, cognitive-behavioral therapy can also be used for patients after coronary artery bypass graft surgery to reduce depression, anxiety and stress and prevent recurrence of the disease. Special attention can also be paid to the psychological factors that cause or exacerbate cardiovascular disease.

Abstract
Aim. This study was conducted with the aim of investigating the effect of family-centered self-care program based on home visits on adherence to physical activity of patients with acute coronary syndrome
Background. Coronary artery disease is one of the most common cardiovascular diseases. The importance of physical activity as an important factor in controlling and preventing the recurrence of the disease in these patients. Adherence to physical activity in patients with acute coronary syndrome (ACS) has a significant effect on preventing re-hospitalization and reducing complications.
Method. In this semi-experimental study conducted in 2021-2002, 72 people with ACS were randomly divided into experimental and control groups (32 people in each group). For the control group, routine interventions, and for the experimental group, family-centered self-care was delivered. Data collection tools were demographic questionnaire and Beck's physical activity level questionnaire.
Findings. Before intervention, there was no statistically significant difference between groups in the mean score of adherence to physical activity. Immediately after the intervention, the mean score in the experimental and control group was 6.31±2.01 and 5.98±1.21, respectively, indicating a statistical significant difference between groups. One and half month after the intervention, the mean score in the experimental and control group was 9.14±1.44 and 78±0.9, respectively, showing a statistical significant difference between groups.
Conclusion. Family-centered self-care in patients with acute coronary syndrome is effective on adherence to physical activity of these patients. Therefore, it is recommended to use this educational method as one of the effective and non-pharmacological methods for people with ACS in medical centers and at home to improve the quality of life among these patients.

Abstract
Aim. The aim of this study was to compare the effect of narrative couple therapy, couple schema therapy and integrative behavioral couple therapy on hope and perceived stress among patients with coronary artery disease and their spouses.
Background. Coronary artery disease is one of the heart diseases that can make couples face problems and need help.
Methods. This research was a semi-experimental study with a pretest and posttest design and with a control group. The statistical population was people with coronary artery disease and their spouses in the winter of 2021. Sixty four couples were selected by purposive sampling method and randomly assigned to three experimental groups and a control group (16 couples for each group). Hope scale of Snyder and perceived stress of Leung et al. were used to assess dependent variables in two stages. The three intervention groups were each treated for 8 sessions of 90 minutes and the control group did not receive any intervention. The data were analyzed by analysis of covariance and post-hoc Bonferroni test.
Findings. The results showed that there was a statistically significant difference of integrative behavioral couple therapy and couple schema therapy with the control group in terms of hope (P≤0.0001), but there was no statistically significant difference between the narrative couple therapy and control group and between three interventions. About the perceived stress, the results showed that there was a statistically significant difference of integrative behavioral couple therapy, narrative couple therapy and couple schema therapy with the control group (p≥0.05).
Conclusion. Considering the effect of integrative behavioral couple therapy and couple schema therapy in increasing hope and effect of the mentioned two interventions and narrative couple therapy in reducing perceived stress among people with coronary artery disease and their spouses. It is recommended to use these interventions in cardiovascular treatment centers.

Abstract
Aim. The aim of this study was to compare the effect of acceptance and commitment-based therapy and emotion regulation education on chronic pain and self-care in women with coronary artery disease.
Background. Research shows that coronary heart disease is one of the leading causes of death and disability in the world, which reduces the useful efficiency of people. Psychological factors can change many aspects of patients' lives and relationships.
Method. The research design was quasi-experimental pre-test-post-test with control group. The statistical population in this study included all women with coronary artery disease referred to Tabriz Heart Hospital in 2020. Women who had inclusion criteria were selected and randomly assigned to the first experimental group (n=15), the second experimental group (n=15) and the control group (n=15). The first experimental group (emotion regulation education) was subjected to 12 sessions of 90-minute duration (three sessions per week), The second experimental group (acceptance and commitment-based therapy) received 8 sessions of 90-minute duration, and the control group did not receive any intervention. The chronic pain scale of Von Korff et al. and the self-care scale of Rigel et al. were used to collect the data. Data were analyzed by multivariate analysis of covariance and LSD post hoc test in SPSS Version 21.
Findings. The results showed that treatment based on acceptance and commitment and emotion regulation education have an effect on chronic pain and self-care of patients with coronary artery occlusion (P ≤0.0001), as they reduced chronic pain and improve patients' self-care. The results also showed that acceptance and commitment therapy has a greater effect on chronic pain and patients' self-care than emotion regulation education.
Conclusion. Attention to acceptance and commitment therapy and emotion regulation education can play a role in reducing the psychological problems of women with coronary artery disease.

Abstract
Aim. This review study was conducted with the aim of highlighting the importance of a preoperative preventive approach in the recovery of patients undergoing coronary artery bypass surgery.
Background. With the increase in the number of patients who are candidated for heart surgery, improving the health status before the operation is of great importance to optimize the results after the operation. This review has been conducted with the aim of evaluating the evidence related to the pre-rehabilitation of patients undergoing coronary artery bypass surgery.
Method. The present literature review was conducted by searching out library resources and databases, Scopus, Chochrane Library, Magiran, SID, PubMed, Up-to-date, OVID, CINAHL, and Web of Science with the keywords, coronary artery bypass surgery, pre-rehabilitation, cardiovascular disease and their Persian equivalents without time limit. From a total of 104 articles, 63 full texts articles entered the review stage, of which 17 articles entered the literature review.
Findings. The findings indicate the favorable effects of pre-rehabilitation on improving the quality of life and preventing complications in the early postoperative period. Pre-rehabilitation programs should adopt multifaceted approaches including nutrition, exercise, and anxiety reduction to improve patient resilience in the preoperative period. The pre-operative period is a critical opportunity to implement pre-rehabilitation interventions for vulnerable patients awaiting cardiac surgery.
Conclusion. Cardiac pre-rehabilitation includes a wide range of preventive interventions that can be taught by nurses to patients undergoing cardiac surgery. Pre-rehabilitation requires an interdisciplinary approach, because it suggests a change from the current model of health care and transformation from one-dimensional care to interdisciplinary care, which can be an effective tool for the medical and nursing system in timely identification of physical and mental disorders in initial preoperative assessment, preoperative education and management, as well as prevention of postoperative complications.

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.

Abstract
Aim. This study aimed to compare the effect of Adaptive Support Ventilation (ASV) and Synchronized Intermittent Mandatory Ventilation-Pressure Support (SIMV-PS) modes on consequence of weaning off patients from mechanical ventilator after coronary artery bypass surgery
Background. The ventilation mode used for respiratory support in patients after coronary artery bypass graft surgery is very important. In addition to avoiding pressure on patient's sternotomy incision, the ventilation mode should also provide the possibility of rapid weaning of patient to avoid complications caused by long-term ventilation.
Method. In a semi-experimental study, 26 patients were ventilated with ASV as the experimental group and 26 patients were ventilated with SIMV-PS mode as the control group after coronary artery bypass graft surgery in Rajaie Cardiovascular Medical and Research Center, Tehran, Iran. Mechanical ventilation time and endotracheal tube removal time, hemodynamic variables, and arterial blood gas analysis were compared between the two groups. Data were analyzed using an independent t-test, repeated measures ANOVA and chi-square.
Findings. Out of 52 patients, 36 (69.2 percent) were male and 16 (30.8 percent) were female. The mean time for the endotracheal tube removal was 89.42±33.83 minutes in the experimental group and 101.53±44.91 minutes in control group, which did not have a statistically significant difference (p=0.843). The mean duration of mechanical ventilation of patients in the experimental group was 483.84±158.153 minutes and in the control group, it was 541.92±257.81 minutes, which were not statistically different (p=0.332).
Conclusion. The use of ASV mode for mechanical ventilation after coronary artery bypass graft did not affect reducing the duration of mechanical ventilation and the time of endotracheal tube removal compared to SIMV-PS mode. Therefore, the use of ASV mode for respiratory support of patients undergoing coronary artery bypass surgery should be considered according to the patient's condition and the nurses' expertise.

Abstract
Aim. The purpose of this study was to investigate the effect of mindfulness training on Corona anxiety in patients with Covid-19 and underlying cardiovascular disease in Imam Ali Hospital, Amol, Iran.
Background. Since its outbreak, the corona virus has shown that it defeats more people with underlying diseases and puts them at risk of death than those who have a healthy body.
Method. This was a quasi-experimental study with control group. The accecible population of this research was all corona patients with a history of cardiovascular disease in Imam Ali Hospital, Amol, Iran, in 2021-2022. Sampling was done from the patients admitted to the hospital based on convenience sampling method. To collect information, the Corona Virus Anxiety Questionnaire developed by Alipour et al. (2018) was used. Mindfulness training based on Kabat-Zinn (2005) educational plan was implemented in experimental group in 8 sessions of 2-hour duration per week.
Findings. The results of multivariate covariance analysis showed that mindfulness training has an effect on reducing anxiety of Corona in patients with Covid-19 and underlying cardiovascular disease to the extent of 0.87 (p≤0.001). Univariate covariance analysis showed that mindfulness training has an effect on reducing the mental symptoms of Corona anxiety in patients with Covid-19 and underlying cardiovascular disease to the extent of 0.83 (p≤0.001). Also, mindfulness training has an effect on reducing physical symptoms of Corona anxiety in patients with Covid-19 and underlying cardiovascular disease by 0.79 (p≤0.001).
Conclusion. Mindfulness exercises can enable patients with Covid-19 and underlying cardiovascular disease to pause and reflect a little before responding, and these pauses provide them with an opportunity. It allows them to get rid of judgment in many situations that can lead to anger, fear and anxiety. This will provide conditions that patients, even in the worst and acute state of their illness, are more likely to be able to maintain their mental peace and thereby, reduce the physical signs and symptoms of anxiety.