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.

Abstract

Aim. The aim of this review study was to describe psychosocial problems in patients with coronary artery disease and determine strategies to prevent and deal with.

Background. The prevalence of cardiovascular diseases is rising in industrial and developing countries. According to the report of World Health Organization, cardiovascular diseases are accounted for a large percentage of mortalities. The most common cardiovascular disease is coronary artery disease that produces problems for people and worries in community.

Method. A systematic search was conducted on studies published in the last 20 years by using databases such as OVID, PROQUEST, SCIENCE DIRECT, GOOGLE SCHOLAR, EBSCO, SID, MAGIRAN and IRAN MEDEX with keywords such as problems, patients, coronary artery disease and related keywords. Because the aim of this study was describing the psychosocial problems of patients after coronary artery disease, physical problems was excluded.

Findings. About 70 article in English and 20 articles in Persian were found about psychosocial problems after coronary artery disease. Patients' problems were categorized in three categories: educational needs of patients with coronary artery disease, consequences of psychosocial outcomes of coronary artery disease, and different consequences for men and women with coronary artery disease.

Conclusion. Because the heart is a sensitive organ, any heart disease can jeopardize patient identity, and psychosocial effects of heart disease is more prominent than physical effects. So, it is necessary to inform patients about the nature of disease and its causes, and how to implement secondary prevention and rehabilitation to return to work and normal life. Accordingly, continuous care for self-care is of great importance. This can be established by community-based clinics for secondary prevention. Especial attention to issues of women with coronary artery disease is essential.

Abstract

Aim.The aim of this study was to compare the eight weeks of combined and aerobic training on body composition and strength in cardiac patient post- coronary artery bypass graft.

Background. Cardiac rehabilitation improves fitness and clinical status in cardiac patients after coronary artery bypass.

Methods. In this randomized clinical trial, 20 cardiac patients under CABG surgery in  Tehran Heart Center were randomly divided into two groups, combined and aerobic training. The protocols of combined group included two movements  of the upper limbs (Pectoralis Major and Deltoid muscles) and two movements of  the lower limbs (quadriceps and Hamstring muscles) by 3 sets/10Rep and  aerobic group  with 60-85 minute exercises at 70-85% peak HR in three sessions per week for 8 weeks. Functional capacity (VO2peak), strength, body weight, BF percentage and WHR were assessed before and after the training protocol. The collected data were analyzed using the Independent and Paired t-tests.

Findings. There was an elevation of functional capacity following, combined (p<0.05) and aerobic (p=0.027) training with a significant further increase in the combined group (p=0.016). The strength increased significantly after combined training (p<0.05). The BF percentage with no significant difference between two groups, decreased significantly following the both training protocols (p<0.05).  

Conclusion. Combined aerobic-resistance training and aerobic training to improve functional capacity in Post CABG cardiac disease.However, Combined aerobic and resistance training is more effective than aerobic training in improving the functional capacity (cardiovascular fitness) and strength.

Abstract

Aim. The purpose of this paper is to introduce the herbal medicines used for cardiovascular diseases and patient education about these drugs.

Method. This study was a systematic review of herbal medicines used for cardiovascular diseases. Herbal medicines were extracted from databases PubMed, Science Direct, and Highwire (Website of Stanford University) using search keywords Herbal, Hyperlipidemia, Heart failure, Cardiovascular and Hypertension. To describe the effective herbal ingredients, side effects, interactions, and patient education, a nursing book on herbs (Kostka et al, 2005) and the Comprehensive Atlas of Medicinal Plants (Stephen et al, 2004) were used.

Findings. Herbal drugs used for cardiovascular diseases in Iran consist of Antum, Alicom, Diuretic, Olea-crat, Crataegus Microphylla and Cratagus.

Conclusion. Some of cardiovascular diseases can be controlled by herbal drugs. Patient teaching about precaution, interaction and avoidance of arbitrary use of drugs are important.

Aim. The aim of this study was to determine the effect of patient education and  nurse-led  telephone follow-up (telenursing) on adherence to treatment in patients with acute coronary syndrome admitted to cardiac care units hospitals affiliated to Alborz University of  Medical Sciences.

Background. Increasing adherence to treatment is essential in patients with acute coronary syndrome to reduce readmissions and improve the recovery, but only patient education does not guarantee the adherence to treatment and it is necessary to follow-up patients after discharge.

Method. This randomized clinical trial study was conducted on patients with acute coronary syndrome admitted to the selected hospitals of Karaj, Iran, in 2014. In this study, 90 patients were selected purposively and randomly allocated  in  three groups of education (n=30), education/ telephone follow-up (n=30), and control (n=30). Data collection instrument was questionnaire. Data were gathered at baseline and 12 weeks after the intervention. Patients in educational groups  (education, and education/ telephone follow-up groups) were trained before discharge using educational pamphlets. Telephone follow-up were implemented for education/ telephone follow-up group for 3 months; twice a week in the first six weeks and weekly in the second six weeks. The data was analyzed by descriptive and inferential statistics in SPSS version16.

Results. After intervention, there was a statistically significant difference between the groups in terms of adherence to treatment (P=0.001). Participants in the education/ telephone follow-up group and education group experienced more improvement in adherence to treatment than the control group.

Conclusion. Both patient education and education/ telephone follow-up have effect on improvement of adherence to treatment, but education/ telephone follow-up results in more improvement in adherence in comparison to education. It is recommended to implement education/ telephone follow-up for patients with acute coronary syndrome.

Aim. This study was conducted to examine the effect of nursing ethics workshop on patients rights practiced by nurses in the emergency department.

Background. According to the goals of 20 years vision and development plans of Iran, moving toward improving the quality and safety of patients and their rights are of the main priorities of health care system approved by national and international experts and authorities.

Method. This study is quasi-experimental study with control group. To measure dependent variable (patient’s right practice by nurses), before and after intervention, perspectives of 180 patients admitted to emergency department were selected by convenience sampling. Intervention was implemented for emergency department nurses. All emergency department staff nurses working in a governmental hospital in the City Shahriar, Iran, were selected. The data were collected through a questionnaire composed of 2 parts, demographic information and 15 questions designed based on patients rights protocol in 5 domains with Likert scale. In order to ensure reliability, Cronbach’s Alpha was calculated for internal consistency coefficient through interviews with 20 patients (&alpha;=0.84). Validity of the questionnaire was evaluated by 10 experts. The questionnaire were completed before and one month after intervention through interviewing with patients admitted to the emergency department during the data collection time period. Data were analyzed by SPSS version 22.

Findings. Before intervention, the mean score of patient’s right practice was 58.83±16.81 and after intervention, the mean score of patient’s right practice increased to 84±8.12. There was a statistically significant difference between the mean total score of patient’s rights practice based on patients perspectives, before and after intervention (p˂0.0001). The lowest score for patient’s rights practice was reported for the domain information giving (15%) and the highest score was reported for the domain respect for privacy (82.7%).

Conclusions. The intervention (nursing ethics workshop) has a positive effect on patient’s rights practice by nurses in the emergency department.