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Alireza Saberi Aliabad , Zahra Alizadeh, Amirreza Rafiei Javazm, Alice Khachian , Masoud Roudbari, Mohammad Reza Zarei,
Volume 13, Issue 1 (3-2024)
Abstract
Abstract
Aim. This study was conducted to examine the effect of distance education based on health belief model on health literacy in people with heart failure.
Background. Inadequate health literacy is strongly associated with adverse clinical outcomes in people with heart failure. Although education of or developing educational material for patient and family members during and in the time of discharge is considered a principle step, it is not enough and the follow up care must be planned.
Method. In this clinical trial, 80 participants were randomly assigned to either experimental or control group. Balanced block randomization with a block size of two was used for allocation. The intervention group received structured education via the “Etaa”, an Iranian messaging application, nurse follow-ups, and routine care, whereas the control group received routine care only. Data were collected using the Heart Failure Health Literacy questionnaire, before the intervention, one month after the intervention, and three months post-intervention.
Findings. The results indicated that the mean health literacy scores in the experimental group were significantly higher than those in the control group (P≤0.0001), with a strong Cohen's d effect size of 2.8.
Conclusion. These findings suggest that educational interventions based on the health belief model can effectively enhance health literacy and adherence to treatment in people with heart failure.
Seyyedeh Zahra Hoseini, Hanieh Gholamnejad, Morteza Mohammadzadeh,
Volume 13, Issue 1 (3-2024)
Abstract
Abstract
Aim. The aim of this study was to examine the relationship of informational support and anxiety among family members of patients admitted to intensive care units (ICUs) in selected educational and medical centers in Hamadan city, Iran, in 2024.
Background. Families of ICU patients frequently experience high levels of anxiety, which may lead to physical and psychological complications. Research indicates that one of the most significant factors contributing to anxiety among family members is a lack of information and familiarity with the ICU environment.
Method. This was a descriptive-correlational study. A total of 191 family members of ICU patients in selected educational and medical centers in Hamadan were recruited using a convenience sampling method, based on predefined inclusion criteria. Data collection tools included a demographic information questionnaire, the Spielberger State-Trait Anxiety Inventory, and Informational Support questionnaire. Data were analyzed using SPSS version 16, applying both descriptive and inferential statistics.
Findings. The findings indicated that the mean anxiety score of participants was 45.7±6.62, with the majority falling within the moderate anxiety range. The mean score of informational support was 46.18±9.78. Pearson correlation test showed a statistically significant positive relationship between the level of informational support and anxiety (r=0.29, P=0.006). One-way ANOVA revealed a statistically significant association between education level and anxiety among family members (F=4.222, P=0.006). Furthermore, informational support was significantly associated with education level and employment status. No statistically significant associations were found between other demographic variables and either anxiety or informational support.
Conclusion. Anxiety among family members of ICU patients is common and typically of moderate severity. Contributing factors include the stressful environment, lack of awareness about the patient's condition, and educational background. Contrary to expectations, increased informational support from healthcare staff did not reduce anxiety and in some cases appeared to increase it, potentially due to the manner of information delivery and the psychological state of family members. These findings highlight the importance of considering demographic characteristics when designing psychological and informational interventions. Recommended strategies include open visitation, education, family involvement, and the presence of a psychologist.
Elham Tavakoli, Fatemeh Golshani, Anita Baghdasarians,
Volume 14, Issue 1 (3-2025)
Abstract
Abstract
Aim. The present study aimed to evaluate a causal model of health anxiety based on spirituality, with the mediating role of cognitive avoidance in Intensive Care Unit (ICU) nurses.
Background. Health anxiety is considered one of the major psychological challenges in clinical settings, particularly among ICU nurses, who face significant psychological and emotional pressures, which can have detrimental effects on their professional performance and personal well-being.
Method. This was a descriptive correlational study. The statistical population consisted of all male and female nurses working in ICUs in Tehran (District 3) during the spring and summer 2024. A sample of 267 nurses was selected via non-random quota sampling, and they completed the Health Anxiety Inventory, the Spirituality Questionnaire, and the Cognitive Avoidance Questionnaire. Data were analyzed using structural equation modeling (SEM) via AMOS 26 software.
Findings. The results indicated that the proposed model has a good fit with the data and accounts for 67 percent of the variance in health anxiety. In the structural model, the direct path from spirituality to health anxiety was negative and significant (â= - 0.655), while the path from cognitive avoidance to health anxiety was positive and significant (â= 0.569). Furthermore, spirituality had a significant indirect effect on health anxiety by reducing cognitive avoidance (â= - 0.288).
Conclusion. Spirituality and cognitive avoidance are key components in explaining health anxiety. These findings emphasize the importance of simultaneously considering internal spiritual resources and cognitive strategies in understanding the structure of health anxiety and provide a theoretical basis for designing psychological interventions to promote mental health among ICU nurses.
Elnaz Pazoki, Fidan Shabani, Marzieh Mirtajaddini, Samira Chaibakhsh, Maryam Moradian, Hamideh Yousefi Mavi, Kambiz Mozaffari,
Volume 14, Issue 1 (3-2025)
Abstract
Abstract
Aim. This study aimed to investigate the relationship of physical activity and sleep quality in patients with heart failure at Rajaie Cardiovascular Medical and Research Institute.
Background. Sleep disorders are among the most common and distressing problems in patients with heart failure, leading to a reduced quality of life and exerting a substantial negative impact on their daily activities and overall well-being. Furthermore, disability and activity intolerance are highly prevalent in heart failure, resulting in chronic fatigue and profound alterations in patient’s lifestyle.
Method. In this descriptive-correlational study, 125 eligible patients attending the heart failure clinic of Rajaie Cardiovascular Medical and Research Institute were selected using consecutive sampling. Data were collected using three questionnaires: a demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the International Physical Activity Questionnaire (IPAQ). Data were analyzed in SPSS using the Chi-square test and the Chi-square test for trend.
Findings. Overall, sleep quality was poor in 53.6 percent of patients and good in 46.4 percent. No statistically significant relationship was found between sleep quality and demographic variables. Regarding physical activity levels during the previous week, 47.2 percent of patients had light activity, 20.0 percent had moderate activity, and 32.8 percent had vigorous activity. Although no significant relationship was observed between physical activity levels and demographic variables, a significant association was noted between rheumatologic disorders and physical activity levels (P=0.011). Ultimately, no statistically significant relationship was found between physical activity levels and sleep quality in these patients. A significant relationship was found only between the subjective sleep quality subscale and physical activity levels, indicating that increased physical activity was associated with improved subjective sleep quality (P=0.024).
Conclusion. Sleep quality was poor in the majority of patients with heart failure, and their physical activity level was predominantly light. Overall, no significant relationship was detected between sleep quality and physical activity levels in this population. These findings can help healthcare professionals incorporate targeted strategies into care plans to address physical activity and improve sleep quality among heart failure patients.
Zahra Jafari, Atefeh Shamsi,
Volume 14, Issue 1 (3-2025)
Abstract
Abstract
Aim. The aim of this review is to summarize the available evidence on the impact of different components of developmental care on physiological, nutritional, behavioral, and family outcomes of infants with heart disease and to identify the challenges of implementing this care in cardiac intensive care units.
Background. Congenital heart disease is the most common congenital anomaly in newborns, and affected infants, especially those undergoing open-heart surgery and prolonged hospitalization in the cardiac intensive care unit, are at significant risk of neurodevelopmental delays. Developmental care has been proposed as a family-centered approach to reduce environmental stress and support infant brain development in this high-risk population, but its implementation in neonatal cardiac unit remains challenging and limited.
Method. In this narrative review, 15 research and review articles published between 2016 and 2025 that directly addressed developmental care, neurobehavioral outcomes, and family involvement in infants with heart disease were screened and analyzed.
Findings. Findings were categorized into four main areas: 1) the role of developmental care in hemodynamic stability and reduction of mechanical ventilation duration, 2) the effectiveness of interventions on feeding patterns and weight gain, 3) the role of parental involvement and Kangaroo care in reducing stress and improving behavioral scores, and 4) barriers to implementing developmental care in cardiac intensive care units, including lack of training, resources, and competing clinical priorities.
Conclusion. The available evidence, although mainly derived from observational and qualitative studies with limited sample sizes, fairly uniformly supports the positive impact of developmental care on short-term outcomes in infants with heart disease. The development of standard clinical guidelines, training of nursing staff, and active family participation are among the main priorities for improving this care in the future.
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