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Aim

 The aim of this study was to evaluate the effect of face-to-face education on knowledge, attitude, and believes of acute coronary syndrome patients about heart disease and their reaction to symptoms.

Background

 Coronary artery disease is known as an important health issue. Mortality results from myocardial infarction are highly dependent on time interval between symptoms presentation and reperfusion intervention. Reperfusion leads to the best results, especially if started within the first 60 minutes after beginning the manifestations. Many studies have been conducted to examine strategies for decreasing delay time, but education through media has not received enough attention.

Method

 In this clinical trial, 300 patients referred to Shahid Radjaee Cardiovascular Hospital and diagnosed as acute coronary syndrome were randomly allocated to receive either education and counseling as intervention (n=150) or regular education (control group, n=50). The inclusion criteria were: not having serious complicated co-morbidity such as psychiatric disorder, renal insufficiency, malignancies or neurologic disorders and speaking and comprehending Pesian. Data collection instruments were demographic form and Rapid Early Action for Coronary Treatment (REACT). Data were collected before intervention and one and three months after the beginning of intervention. The data were analyzed by SPSS.

Findings

 The study findings showed high rate of reporting risk factors in both groups. Most patients of both groups had referred to cardiologist. In experimental group, knowledge, attitude and belief scores increased significantly, one and three months after the beginning of the intervention. Between group comparisons showed a statistically significant difference between two groups in terms of knowledge, attitude and belief scores (P≤0.0001).

Conclusion

 Face-to-face education and counseling improves knowledge, attitude and believes of the patients about acute coronary syndrome, thereby, may reduces delay in treatment. Improvement of patients’ knowledge is the basic step for symptom management of the acute coronary syndrome.

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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.

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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.

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Abstract

Aim.The purpose of this study was to assess the relationship of nutrition knowledge and physical activity level with total cholesterol, high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) in men with myocardial infarction (MI).

Background. Myocardial infarction is the most common cardiovascular disease and considered as the main cause of mortality in the world including Iran. The studies show modification of unhealthy lifestyle is a preventive method in cardiovascular diseases.Nutrition knowledge and physical activity are important factors in reducing serum lipid levels and prevention of cardiovascular disease, particularly myocardial infarction. Modification and promotion of nutrition knowledge and physical activity levels in individuals with history of cardiovascular disease may reduce the risk of myocardial infarction.

Method. This is a quasi-experimental study in which 150 men from Milad Hospital in Tehran (mean age of 58.01 with standard deviation of 3.58 years, mean weight of 80.8 with standard deviation of 13.18 Kg, and mean height 174.24 cm with standard deviation 6.43 cm) were selected by Morgan table to fill two questionnaires of nutrition knowledge (Wardle 1999) and of physical activity level. After 12 hours fasting, HDL-C, LDL-C and total cholesterol levels were measured in all subjects. The data was analyzed in the significance level of 0.05.

Findings. The findings showed that there was a statistically significant correlation of nutrition knowledge and physical activity level with LDL-C and total cholesterol in adult men with MI, but no significant correlation with HDL-C was found.

Conclusion. According to the results, with promoting nutrition knowledge and physical activity level in men with MI, the risk of cardiovascular diseases (especially myocardial infarction) can be controlled.

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Abstract

Aim. This study  aimed to explore the effectiveness of storytelling technique on professional communication skills of  nurses in critical care units of ShahidRajaee Heart Center.

Background.  Patient Communication  skill is one of the most important aspects of nursing profession that can improve the overall abilities of  nurses and  health care team. Sharing the tacit knowledge on patient communication skills is one of the issues with which nursing system encountered. Retirement of experienced  nurses causes  a considerable loss of  tacit knowledge. One of the best ways to transfer tacit knowledge is to apply the storytelling  technique in transferring these experiences.

Method.This  was a quasi-experimental study with control group. It was conducted on 130 nurses, working in the ICU, who were randomly divided into groups of  intervention and control. The intervention group was instructed via storytelling on clinical experiences within 6 hours. The effect of the intervention was tested through a self-reflective questionnaire completed by both groups before the intervention and  one month later. To analyze the data, paired and independent T-test, Chi-square, Fisher exact test, Mann-Whitney U test and the analysis of covariance via SPSS version 21 were applied.

Finding. Results showed that the intervention and control groups` pre-test scores were 104.60 with standard deviation of 7.60 and 103.13 with a standard deviation of 9.60, respectively. Furthermore, their post-test scores were estimated  as 117.92  with a standard deviation of  4.37 and 102.25 with standard deviation of  8.66 accordingly. There was a statistically significant difference between the post-test scores of intervention and control groups regarding their professional communication skills (p< 0.001). According to the sample based effect sizes, 71.4% of the variability in the post-test is caused by the intervention.

Conclusion. Based on the findings, it can be concluded that storytelling technique enhances the clinical competency of nurses in terms of professional effective communication with both patients and colleagues. Therefore, this technique can be introduced as an effective way to promote professional communication.

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Abstract

Aim. The aim of this study was to determine the effect of training cardiopulmonary cerebral resuscitation management on knowledge of nurses working in maternity wards of Ganjavian Hospital, Dezful, Iran, in 2013.

Background.Cardiaopulmonary cerebral arrest is one of the most dangerous situations that threats the life and requires immediate and appropriate action to survive and protect life and prevent irreparable/irrecoverable complications of the body vital organs.

Method.This is a quasi-experimental pretest-posttest study in which 40 nurses employed in maternal wards of Ganjavian Hospital in Dezful were recruited. The tool used in this study was a researcher-made questionnaire including 20 questions to determine the knowledge of nurses about cardiopulmonary cerebral resuscitation management. After the content validity and reliability of the questionnaire was confirmed, it was distributed among and completed by the participants, before and after intervention. Training workshop was conducted in the form of lecture and practical training on manikin, 8 hours per day for 2 days in both basic and advanced level. The data were analyzed using SPSS 17.

Findings. Maximum and minimum scores of pretest were 13 and 5, respectively, with a mean of 9.90 and standard deviation 7.9. Maximum and minimum scores of post-test were 15 and 8, respectively with a mean of 11.25 and standard deviation 1.6. There was a statistically significant difference between scores of nurses’ knowledge, before and after training (P<0.0001)

Conclusion.The findings provide strong evidence, supporting the important role of holding continuous in-service training courses of cardiopulmonary cerebral resuscitation to improve scientific qualification of the nurses. It is recommended to put more emphasis on resuscitation management process and standardization of the efforts of resuscitation team during emergency events.

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Abstract

Aim. This study assessed the knowledge of nurses about arterial blood gases interpretation in intensive care units of selected hospitals in Tehran.

Background. Measurement of arterial blood gases are widely used in intensive care units. The knowledge and mastery in interpretation of arterial blood gases is an essential skill for critical care nurses.

Method. This descriptive-analytical study was conducted on 117 nurses working in intensive care units at selected military hospitals in Tehran in 2013. Data were collected using a questionnaire consisted of 45 questions about personal and professional information, also in the domain of blood gases interpretation based on Bloom's classification of knowledge (judgment and evaluation phase). Data are analyzed by SPSS and descriptive and inferential statistics were presented.

Findings. Knowledge of intensive care unit (ICU) nurses was moderate to poor in arterial blood gas interpretation. A statistically significant difference was seen between the knowledge of the subjects in terms of some variables. Conclusion. Given the importance of arterial blood gases interpretation in ICUs, it is necessary to pay attention to in-service and continuing education programs for nurses.

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Abstract

Aim.The aim of this study was to compare the effect of education through lecture and multimedia methods on knowledge, attitude, and performance of cardiac care nurses about temporary pacemaker care.

Background.Cardiac dysrhythmias are among the most common cardiovascular disorders. Temporary pacemaker insertion is a treatment or prevention method for cardiac dysrhythmia. Nurses are the main group to provide the care for patients with temporary pacemaker, so it is necessary to educate them in an effective and efficient way.

Method.This was an experimental study conducted in 2015 on 52 cardiac care nurses working in ShaheedRajaei cardiovascular center. All 52 nurses were randomly divided in 2 groups of education through lecture and multimedia. The level of nurses' knowledge, attitude and performance was evaluated before and three weeks after education and the effect of education was examined using Mann-Whitney and Wilcoxon Signed Ranks Test through SPSS version 22.

Findings.Before intervention, the median and interquartile range of knowledge levels for lecture and mul-timedia groups were 12.5 (10-14) and 11 (9-12), respectively, and after that, they increased to 17 (15- 19) and 17 (13- 19). The median and interquartile range of performance levels for lecture and multimedia groups changed from 29 (26- 30) and 30 (26- 31) to 34 (32- 35) and 34 (32- 35), respectively. The knowledge and performance levels increased in both methods. But there was no statistically significant difference between these two methods. Before intervention, the median and interquartile range of attitude levels for lecture and multimedia groups were 62.5 (60-64) and 64 (63-66) and after that, they changed to 64 (60-64) and 63 (61-64), showing that intervention has no effect on attitude level in any of these two groups.

Conclusion.There is no difference between the effectiveness of education through two methods of lecture and multimedia software on cardiac care nurses' knowledge, attitude and performance. In the other words, multimedia software method is as effective as lecture method. Education using multimedia software can be considered as a proper method for increasing demand in staff education. Proper infrastructure and optimal training programs are prerequisites to effectiveness of education through multimedia software method.

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Abstract

Aim. This study aimed to examine the effect of education by video self-assessment on nurses’ knowledge and performance about cardiopulmonary resuscitation (CPR).

Background.Cardiopulmonary arrest is one of the main medical emergencies and one of the major causes of death around the world. Cardiopulmonary resuscitation is the critical components of basic life support in response tocardiopulmonary arrest. The success ofcardiopulmonary resuscitationrequiresproficiencyandperformance of resuscitation group.

Method. This was a clinical trial study conducted on 80 nurses that were randomly divided into experimental and control group. Participants in control group received traditional training and experimental group experienced video self-assessment after traditional training. Knowledge on CPR was evaluated with a valid questionnaire including multiple choice questions. Psycho-motor skills were measured through a visual checklist observing CPR performance of the participants on a manikin. Outcome variables were measured three times (before, immediately after, and two months after training). Data were analyzed by the SPSS through repeated measures analysis.

Findings. Comparing the mean score of knowledge between the groups at before, immediately after, and 2 months after training did not show any statistical significant difference. Immediately, and two months after intervention, the mean score of performance of the experimental group was significantly higher than that of control group.

Conclusion.Education by Video self-assessment is an effective method to improve nurses’ performance in CPR.

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Abstract

Aim.The aim of this literature review was to study medical staff knowledge about cardiopulmonary resuscitation for pregnant women.

Background.Cardiopulmonary resuscitation (CPR) in pregnancy is a rare event. Although rare, CPR during pregnancy is very important, because saves the life of the mother and fetus. Knowledge of medical staff and their formal training on CPR in pregnancy are such factors affecting the maternal and fetal outcomes. Knowing the state of medical staff knowledge in this area will help recognize the existing gaps and plan for improvement.

Method.In this narrative review, databases such as Medline, Science direct, Ovid, Scopus, SID, Magiran and Barakat Knowledge Network System was used to data collection. Articles published between 2000-2016, were searched out by the keywords "cardiopulmonary resuscitation",‌"pregnancy", "knowledge","medical Staff", both inPersian and English. Inclusion criteria was content similarity to subject under study. 

Findings. Out of 20 retrieved papers, 4 cross- sectional analytical articles published between 2008-2012 was selected and reviewed for describing the state of medical staff knowledge on CPR in pregnancy. The knowledge of medical staff was in poor level in different areas such as proper pregnant patient positioning during CPR, sequence of bag- mask ventilation and intubation, defibrillation (application during pregnancy, paddle placement location, energy and considerations), the use of drugs and therapeutic doses and cesarean section in within 4-5 minutes following CPR failure.  

Conclusion.The knowledge of medical staff about CPR in pregnancy is poor. Establishing continuous educational course to improve their knowledge is recommended. 

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Abstract
Aim. The purpose of this study was to determine the knowledge and attitude of Isfahan people about prevention of cardiovascular disease.
Background. Cardiovascular disease is the main cause of death and disability in all societies. Lack of knowledge about risk factors of heart disease is associated with unhealthy lifestyle and increasing progression of cardiovascular disease.
Method. This descriptive analytical study was conducted in 2016 on 384 people of Isfahan, located in the centre of Iran. Data was collected by a researcher-made questionnaire with three parts of personal information, awareness and attitude questions about prevention of cardiovascular disease. The data were analyzed in SPSS 16 using descriptive and inferential statistics.
Findings. Participants had good knowledge of the prevention of cardiovascular disease (with the knowledge mean score of 13.11±1.94 of the maximum score 14). Also, people's attitudes towards cardiovascular disease prevention were positive (with the mean score of 30.6±4.05 of maximum score of 40). There was not a statistically significant difference between the score of knowledge in terms of age, sex, marital status and family history of heart disease, but knowledge about prevention of heart disease was associated with the previously received training and educational level. There was not a statistically significant difference between the score of attitude in terms of demographic characteristics.
Conclusion. The knowledge and attitude about prevention of heart disease among Isfahan people was good and associated with the previously received training. So, providing educational programs about risk factors of cardiovascular disease may improve knowledge of and attitude towards heart disease and play an important role in improving lifestyle and prevention of cardiovascular diseases.

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Abstract
Background. Self-care behaviors in cardiac patients are one of the essential factors in their treatments. The failure to apply proper self-care behaviors reduces their recovery and imposes high costs on the health care system.
Aim. This study aimed for design and psychometric measurement of the questionnaire on attitude, knowledge and utilization of self-care for patients undergoing coronary artery bypass graft surgery based on Waltz model
Method. In this methodological study, the following four steps were conducted for design and psychometric measurement of the questionnaire: 1) defining the theoretical and practical self-care concept for patients undergoing coronary artery bypass graft surgery in the domains of physical activity, sexual activity, social activity, mental state, and smoking; 2) designing the items of the questionnaire using other instruments which are being used in heart diseases; 3) determining the face validity (the assessment of facility, difficulty, and ambiguity of the items and their importance for patients) and content validity of the questionnaire (the assessment of appropriateness and necessity of items by experts opinions and measuring CVR and CVI; 4) the internal consistency of the questionnaire was evaluated by determining the Cranach's alpha coefficient.
Findings. The first version of this questionnaire was produced with 56 items, of which 15 items were deleted during the process of validity and reliability confirmation. The final version of the questionnaire was provided with 41 items in three domains; knowledge domain with 14 items, attitude domain with 7 items and utilization domain with 20 items. The results of the psychometric procedure for the questionnaire was the content validity index of 0.99, the content validity ratio of 0.96 and the internal consistency of the questionnaire with Cronbach's alpha coefficient of 0.7 representing appropriate validity and reliability of the questionnaire.
Conclusion. This 41-item questionnaire can be utilized in the assessment process of these patients. Measuring construct validity is recommended for the validity of the domains of the present questionnaire.

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Abstract
Aim. This study aimed to assess knowledge and practice of nurses about nursing care before and after cardiac catheterization
Background. The most common cause of death in most countries around the world is cardiovascular disease. Coronary angiography is an invasive procedure that is used to diagnose and/or treatment of coronary artery disease. Considering complications of cardiac catheterization, nursing care is of great importance in preventing and identifying complications. Standards are the least acceptable, expected and achievable levels of performance based on which it is possible to evaluate performance. Nurses and health care providers should work according to standard protocols.
Method. This descriptive analytical study was conducted on 65 nurses who were selected by census sampling method and based on inclusion criteria from cardiac catheterization wards of selected hospitals in Tehran, Iran. Data were collected by a questionnaire and a checklist prepared in accordance with the standards provided by the Ministry of Health and the Iranian Nursing Organization. The data were analyzed in SPSS version 21 using descriptive and inferential statistics.
Findings. Most of participants were female (63 percent). The mean score of knowledge about nursing care before and after angiography were 10.95±1.30 and 15.23±1.88, respectively. The mean score of performance about nursing care before and after angiography were 26.16±2.92 and 25.77±4.78, respectively; according to these findings the knowledge and practice of nurses about nursing care before and after angiography were evaluated as good. There was no statistically significant difference between female and male nurses in terms of knowledge and practice. Also, no statistically significant relationship was found between the knowledge and practice, before and after angiography.
Conclusion. Although most nurses had good scores of knowledge and practice about nursing care before and after angiography, but due to lack of some principles of care in their performance, further studies is recommended. Also, it is necessary for managers to provide nurses with care protocols.

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