The aim of this study was to compare attitude of the last-year nursing and medical students studying at Iran University of Medical Sciences, Tehran, Iran about spiritual care

Background

The spirituality is a complex and multidimensional concepts including cognitive, behavioral and experimental aspects. For promoting spiritual care we have to consider the physical, mental, emotional and spiritual aspects of the human. The studies showed that many patients believe that spirituality plays an important role in their life they believe there is a positive relationship between their recovery and religious and spiritual aspects. Many patients expect health care personnel consider these factors

Method

A descriptive comparative design was used to conduct the study. “Spiritual care perspective scale” (SCPS) was completed by 110 nursing and 220 medical students. Data were analysed by SPSS.

Findings

Based on the findings, 56% of nursing students and 51.8% of medical students have positive attitude on the spiritual care of patients. There was no statistically significant difference between attitudes of the two groups of students. Nursing students had more favorable attitude about existing a superior force or transcendental existence influencing spiritual health. Medical students had more favorable attitudes about considering spiritual care as part of the caring performance.

Conclusion

Aim. The aim of this study was to compare the quality of life (QOL) in patients after coronary artery bypass graft surgery (CABG) and percutaneous transluminal coronary angioplasty(PTCA), before surgery and three, six and twelvemonths after surgery.

Background.CABG and PTCA are common treatments in coronary artery disease(CAD). After PTCA the patient is hospitalized only for one day and pays less than CABG,but it is not obviouswhether there is any difference between the quality of life in these two groups.

Method.This prospective cohort study was conducted on 241 patients (115 PTCA and 126 CABG patients) who were hospitalized in Tehran University of Medical Sciences hospitals between 2004-2006. The data were collected by questionnaire including 40 questions regarding demographic data, disease information and quality of life. The data were analyzed by statistical tests including T- test, Fisher's exact test, Wilcoxon and Friedman.

Findings.The findings showed that both groups hadreduction in the quality of life(P≤0.001), but the QOL had statistically significant difference in both groups three, six and twelve months after surgery (P≤0.001).

Conclusion.Patients and their families need to be supported and trained by health care team after performing each of these surgeries and encouraged to follow up their disease status.

Aim. The aim of this study was to investigate percpectives of patients with cardiovascular disease about barriers and benefits of health promotion behaviors.

Background. Based on Pender’s health promotion model, certain emotional behaviors such as perceived benefits and barriers have effect on changing health behaviors.

Method. In a descriptive cross sectional study, 260 patients with cardiovascular disease were selected from exercise tolerant test ward of Shahriar social security hospital in 2009. In this study, sampling method was simple. Data were collected through interview.  The instruments included demographic form, Benefits Assessment Scale and Barriers Assessment Scale. The data were analyzed by using SPSS software and descriptive statistics, T-test, ANOVA and Pearson coefficient correlation.

Findings. The findings showed that mean score of perception of health promotion behaviors benefits was 41.14±3.82, and 83.7% of patients had high scores of perception about benefits of health promotion behaviors. There was statistically significant correlation of perception of benefits with education level (P=0.024) and job (P= 0.021). Mean score of perception of health promotion behaviors barriers was 26.81±6.31 and 66.3% of patients had moderate scores of perception about barriers of health promotion behaviors. Perception of barriers was significantly associated with gender (P=0.034) and marital status (P= 0.047).There was negative significant correlation between perception of benefits and perception of barriers (p=0.001).

Conclusion. Regarding the results of this study, seems that increasing perception of patients with cardiovascular disease about benefits of health promotion behaviors is associated with decreased barriers of health promotion behaviors. Educational interventions by professional nurses for patients with cardiovascular disease may help the patients to adherence to health promotion behaviors.

Aim. The aim of this study was to determine sharp instruments injuries in intensive and general wards of Rasoule-Akram hospital in Tehran in 2010.

Background. Sharp instruments can cause transmission of blood-borne pathogens such as Human Immune Deficiency Virus (HIV), Hepatitis B (HBV) and Hepatitis C (HCV). Annually, there are 66000 HBV, 16000 HCV, and thousands of HIV cases as a results of contact with sharp instruments among health care personnel around the world. Nurses are almost involved in all sharp instrument injuries.

Method. This descriptive-analytical study was conducted on 76 nurses of medical-surgical wards and 44 nurses of intensive care units. Data were collected by using Virginia University Questionnaire (Prevention Information Network) for assessing sharp instrument injuries. The data was analyzed by SPSS software.

Findings. The finding showed that most injuries occur in patient's room and the lowest in the treatment room.  Also, 55.8% of all patients have done no action after injury, %35 of them is followed by wards and 9.2% of them are not followed by wards.

Conclusion.  According to high frequency of sharp instrument injuries, it is necessary to provide health care personnel with educational programs. Appropriate education may have significant effect in decreasing injuries among health care personnel.

Aim. The aim of this study was to assess the effect of anti-embolism stocking in preventing lower limb edema following saphenous vein harvesting in patients undergoing coronary artery bypass graft surgery (CABG).

Background. Saphenous vein harvesting in the CABG may cause leg edema and compression therapy commonly used for the prevention of this problem.

Method. This prospective cohort study was conducted on 106 patients underwent elective CABG in Tehran Shahid Rajaei cardiovascular center from June 2011 to March 2011. Following the surgery, at the end of the fourth week, the patients were divided into two study groups according to the method of anti-embolism stocking usage. The first group regularly and consistently used the anti-embolism stocking following surgery (anti-embolism stocking group), whereas the second group did not use anti-embolism stocking, or irregularly used it (control group). The severity of the lower limb edema and changes in the circumference of the legs and thigh were analyzed following the surgery between two groups.

Findings. The findings showed that four weeks after the surgery, the incidence and the severity of the lower limb edema were significantly lower in the anti-embolism stocking group (P≤0.001). Also, the postoperative increase in leg circumference was significantly lower in anti-embolism stocking group, but there was no statistically significant difference between two groups in terms of thigh measurements (P≤0.05). The findings showed that weight and daily activity significantly correlated (P = 0.035 and 0.002 respectively) with the occurrence of lower limb edema, but there was no statistically significant correlation of occurrence of lower limb edema with age, gender, height, the use of diuretic, diabetes, low-salt diet, cardiac postoperative complication, donor leg ulcer complication and method of saphenous vein use.

Conclusion. This study showed that the regular use of anti-embolism stocking has a significant effect for the prevention of the lower limb edema and reduction of its grade, following the saphenous vein harvesting in CABG patients.

Aim. This study aimed to evaluate the effect of cardiac rehabilitation on the quality of life in patients undergoing coronary artery bypass graft surgery (CABG).

Background. Nowadays, CABG is common in many patients to treat complications of the cardiovascular disease.

Method. This quasi-experimental study was conducted on 100 patients after coronary artery bypass graft surgery procedure (CABG). Based on objective and with regard to the inclusion criteria, the subjects were randomly divided into two groups of experimental and control groups. Cardiac rehabilitation program was conducted 24 sessions for the experimental group and the control group followed the usual program. Data were collected by demographic and SF-36 quality of life questionnaires at discharge (at the beginning of rehabilitation), the fourth week (after twelfth session) and the eighth week (after twenty fourth session) of cardiac rehabilitation. The data were analyzed by using Chi-square, independent T and RMANOVA tests.

Findings. The findings showed that the experimental and control groups were not significantly different with each other in terms of demographic variables. Comparison of experimental and control groups by using independent T-test showed that approximately there was statistically significant difference in all quality of life components after 12 sessions of cardiac rehabilitation in experimental group (4 weeks after control group discharge). Also, the comparison of both groups showed that after 24 sessions of cardiac rehabilitation in experimental group (8 weeks after control group discharge), there was statistically significant difference in variables such as physical functioning, general health, vitality, emotional role (emotional limitations), mental health, physical and mental health component and quality of life.

Conclusion. The results indicate a significant improvement on quality of life with cardiac rehabilitation intervention therefore, it is necessary to emphasize and encourage cardiac rehabilitation.

Aim. The aim of this study was to assess the prevalence of cardiovascular risk factors among the Sharif University of Technologystudents.

Background. Coronary Artery Disease (CAD) is a leading cause of mortality and disability in Iran and obesity is considered as one of the main causes. The primary prevention is a solution for prevention of this disease, especially from an early age. The studies regarding prevalence of cardiovascular risk factors are limited and unavailable in the university students especially in engineering students. 

Method. This cross-sectional study was conducted on 223 Sharif University of Technology students (150 male, mean age 20.33؛ and 73 female, mean age 20.36).  Data were collected by using questionnaire, blood analysis and anthropometric measurements.

Findings.The prevalence of overweight and obesity was 19.29% (male: 22.66%, female12.33%) and central obesity based on waist circumference index was 21.97% (male: 18%, female: 30.14%). Also, 60.09% of subjects were inactive and 43.5% had low HDL-C. High triglyceride levels and hypertension were observed in subjects (12.21% and 14.8%, respectively). There were at least two cardiovascular risk factors in 87% of subjects. There were positive correlations of body mass index with systolic blood pressure (r =0.224, P=0.0005) and triglyceride (r=0.147, P=0.014) and negative correlation between body mass index and HDL-C (r=-0.189, P=0.002).

Conclusion. The results showed that the prevalence of cardiovascular risk factors is high among the students therefore, it is necessary to provide an appropriate evaluation and solution for prevention and health promotion.

Aim. The aim of this study was to determine prevalence and causes of fever in hospitalized

patients at intensive care unit (ICU) and its associations with the demographic characteristics .

Background. Fever is a common problem. About 70% of hospitalized patients in the ICU have

fever, which can lead to increased mortality rate in them.

Method. This descriptive analytical study was conducted on 110 patients in the Intensive Care

Units of Sanandaj educational hospitals who had no fever on arrival in the ICU and had a higher

temperature than the 38.3°C, after 24 hours. Data were collected from March to July 2008 by a

standard questionnaire which completed and coded by the researcher. The data were analyzed by

using SPSS software.

Finding. The findings showed that the infectious causes of fever were respectively infections

caused by catheter (38.02%), ventilator associated pneumonia (34.5%) and complications caused

by wounds infections (14.5%) also the majority of non-infectious causes of fever were due to

aspiration pneumonia (29.1%). The Chi-square test showed statistically significant correlations

of age (P<0.01), duration of hospitalization (P<0.05) and the Glasgow Coma Scale (GCS) of

patients (P <0.01) with fever.

Conclusion: Fever incidence in the ICU patients is a relatively common complication. In this

study, the frequency of this complication is similar or even lower than studies done in other areas

and indicates that, despite of lower health care facilities in the study area, the principles of infection

control and patient care has been considered.

Aim. The aim of this study was to evaluate the impact of cardiac rehabilitation on hemodynamic parameters

in patients undergoing coronary artery bypass graft surgery (CABG).

Background. Nowadays, CABG is common to treat complications of cardiovascular disease in many

patients.

Method. This clinical trial study was conducted on 50 patients after CABG. The patients were selected

based on objective and with regard to the inclusion criteria. Rehabilitation program was conducted for 24

sessions. Data were collected by demographic questionnaire and hemodynamic parameters checklist at the

beginning of rehabilitation, 12th session and 24th session of cardiac rehabilitation. The data were analyzed

by using Chi-square, RMANOVA tests and SPSS software.

Findings. The groups in terms of demographic variables were not significantly different with each other.

The findings showed statistically significant differences in variables such as systolic blood pressure, pulse

rate and arterial hemoglobin saturation. There were significant differences in these variables between the

first and the last sessions (session 24), also between the first session and during the rehabilitation (session

12). There was a significant difference between the 12th and the end of rehabilitation (session 24) in the

diastolic blood pressure (p=0.045), but no significant differences in other hemodynamic parameters were

seen.

Conclusion. The results indicate a relative improvement in some hemodynamic parameters with cardiac

rehabilitation intervention therefore, it is necessary to pay more attention to the cardiac rehabilitation.

Aim. The aim of this study was to determine the family members’ performance in confront with

patient's heart attack and its relationship with their knowledge in this filed.

Background. Heart attack is one of the most common, serious and fatal diseases. It is growing

rapidly worldwide and is the most leading cause of mortality. The performance of people who

deal with the heart attack patients in the early minutes, is important in prognosis of disease and

his/her life and death .

Method. This correlational descriptive study was conducted on 300 family members of

patients with heart attacks who hospitalized in teaching hospitals of Iran University of Medical

Sciences. Data were collected by a questionnaire and continuous sampling. Validity of

questionnaire was confirmed by content validity and its reliability were confirmed by test-retest

and by internal consistency ( 0.92).

Findings. The findings showed that there was good level of knowledge, but poor performance

of the subjects in confront with patient's heart attack. There was statisticaly significant

correlations between performance and the knowledge (p=0.004), but no significant correlations

between performance and the knowledge with level of education, age and gender.

Conclusion. Despite of good level of knowledge in target community, none of them have good

performance in the confront with heart attack patients therefore it is recommended to educate

the public on how to deal with heart attack patients and to perform more studies in this field

in order to offer appropriate strategies to promote the knowledge and performance of family

members and individuals in society.

Aim. The aim of this study was to determine the effect of first phase cardiac rehabilitation

programs on anxiety and depression in acute coronary syndrome (ACS) patients.

Background. Anxiety and depression are psychological factors influencing the prognosis,

recovery, and adherence to treatment in patients with ACS. Cardiac rehabilitation programs are

an important part of the care plan is arranged for the majority of heart patients.

Method. This clinical trial study was conducted on 88 ACS patients with regard to the inclusion

criteria. The subjects were randomly divided to experimental (n=44) and control (n=44) groups.

The experimental group participated in four educational sessions of cardiac rehabilitation

program, which included familiarity with risk factors of heart disease, nutrition and drugs

recommendations, stress and depression reduction methods and exercises training. Information

booklet was given at the end of the sessions. Data were collected by demographic and diseaserelated

questionnaires and Persian version of Hospital Anxiety Depression Score (HADS).The

data were analyzed by SPSS software version 16.0 and descriptive and analytic statistical tests

(Independent t-test and Chi-square and Fisher's exact test).

Finding. The findings showed that there was no statistically significant relationship of

demographic and disease-related information with anxiety and depression scores before study.

There was significant statistical difference between two groups in the mean of anxiety and

depression score after intervention (P_0.0001).

Conclusion. According to the finding, the first phase cardiac rehabilitation programs is effective

in reducing anxiety and depression in ACS patients Therefore, it can be an effective way to plan

nursing care of patients with ACS.

Aim. The aim of this study was to evaluate the knowledge of women about cardiovascular diseases risk

factors.

Background. Prevalence of cardiovascular diseases risk factors is increasing rapidly worldwide with

development of modernity and urbanization.

Method: This cross-sectional study was performed on women with age range of 14-66 years old. The

sample size was 735 women. Convenience sampling was used to recruit the participants. Data were

collected by a researcher-made questionnaire whose validity and reliability were confirmed by content

analysis and test-retest methods. The data were analyzed by using SPSS software with appropriate

statistical tests.

Findings: The mean age of participants was 23.4± 5 years. The average body mass index of them was

21.7±3 kg/m. 50.1% of them had little information about cardiovascular diseases. The most common of

data gathering sources were radio and TV (65.3%). The most common of cardiovascular diseases risk

factors included smoking (93.2%), psychological stress (92.8%), obesity (91.2%), high blood triglyceride

(89.4%), and fatty rich food consumption (88.7%). 75.2% of participants achieved at least 50% of the mean

knowledge score. There were significant statistical correlation between knowledge score and increasing of

age and educational level and applying visual media such as TV (p=0.012, p=0.039, p=0.003 respectively).

There was no significant correlation between knowledge score and both marital and economic status.

Conclusion: It’s suggested to design educational programs according to age, gender, educational level and

culture of different groups of society in order to promote knowledge and control cardiovascular diseases

risk factors.

Abstract

Aim. The aim of this study was to evaluate cardiac intensive care nurses’ performance in usingintravenous Streptokinase for acute myocardial infarction patients.

Background. Acute myocardial infarction is a common disease. Use of thrombolytic drug includingStreptokinase reduce mortality rate in these patients. Nurses have an important role in injectingthis drug.

Method. This descriptive study was conducted on 68 nurses who work in cardiac emergency room andcoronary care unit. Data were collected by observation check list of nurses’ performance. The data wereanalyzed by descriptive statistic and Chi-square.

Findings. The findings showed that the manner of presenting nursing care in pre- Streptokinase infusionstage was moderate in 52.9% of observations, but during the injection in 55.4% of observations and afterinjection, in 45.6% of observations was poor.

Conclusion. The care of patients was moderate and poor, therefore it is recommended to paymore attention to education of nurses about using intravenous Streptokinase for acute myocardial

Abstract

Aim. This study was conducted with the aim of evaluating mental health status in critical care nurses working in Coronary Care Unit (CCU), Intensive Care Unit (ICU), Emergency Department (ED) and dialysis ward in teaching hospitals of Tehran, Iran.

Background: Nursing is known as a difficult profession which needs an endless patience and tolerance with patients and their families. Furthermore, nurses must update theirs knowledge in all nursing-related topics, but it seems that it is so hard for nurses to update knowledge and at the same time, do their professional tasks such as meeting patients and family needs which occupy nearly all their time. This could run them at risk mentally and physically. Besides, it is much more possible for critical care nurses to be affected because of aggravated work-related stresses.

Method: This is a cross- sectional descriptive study. The sample included 375 critical care nurses with at least one year of nursing experience and six months of working in critical care wards. The convenience sampling method was used. Three valid and reliable questionnaires were used in this

study: "Chalder Fatigue Questionnaire", "Hamilton Anxiety Rating Scale", and "Pittsburgh Sleep Quality Index". Questionnaires were filled by study participants and the data were analyzed by SPSS.

Findings: The findings revealed that %73 of nurses experienced mild levels of anxiety, and %16.5 of them reported mild to moderate levels of anxiety. The remaining had either moderate to severe or severe levels of anxiety. Regarding sleep quality, %89.2 of the samples had bad sleep quality. In terms of fatigue, all participants reported moderate to severe fatig.

Conclusion: Critical care nurses in teaching hospitals of Tehran do not have satisfying mental health status. Most of them are suffering from bad sleep quality, moderate to severe fatigue, and mild or mild to moderate anxiety.

Abstract

Aim. The aim of this study was to examine the effect of muscle relaxation and music therapy on anxiety level in patients waiting for cardiac catheterization.

Background. Anxiety is one of the most common human emotions from positive or negative experiences of life. High levels of anxiety have many unwanted effects on the body systems. In stressful situations such as invasive diagnostic techniques, the person experiences high level of anxiety. One of the main responsibilities of nurses is to control anxiety in patients with pharmacological and non-pharmacological methods.

Method. This quasi-experimental study was conducted in one hospital affiliated to Tehran University of Medical Science. After obtaining approval and written consent, 150 patients, waiting for cardiac catheterization, were randomly divided into three groups of muscle relaxation, music therapy and control. Data were collected by demographic form and self-report form of anxiety through interview. One hour before cardiac catheterization, the level of anxiety was measured in all groups, then, muscle relaxation group was asked to perform Benson muscle relaxation for 20 minutes based on listening to a recorded tape of guidance by headphone. At the same time, the music therapy group listened to music tape by headphone. Control group received no intervention but standard nursing care. Immediately before cardiac catheterization, the level of anxiety was measured again in all groups. Data were analyzed by SPSS using Fisher exact test, Mann-Whitney and Kruskal-Wallis tests.

Findings. Immediately before catheterization, patients' anxiety level was significantly reduced (p<0.001) in muscle relaxation and music therapy groups, while it increased in the control group. Immediately before catheterization, a statistical significant difference was found between levels of anxiety in groups (p<0.001).

Conclusion. Both Benson muscle relaxation and music therapy significantly reduced anxiety level of patients and music therapy had more effect on the anxiety level of patients waiting for cardiac catheterization.