Cardiovascular Nursing Journal

The effect of two ways of using the phone and SMS follow-up care on treatment adherence in Coronary Artery Bypass Graft patients

Maryam Jadid Milani

Abstract

Background. One of the most important aspects of care and follow-up after coronary artery bypass graft surgery is treatment adherence program. As the long term success of the surgery depends on the treatment of adherence plan.

Aim. The purpose of this study was to evaluate the efficacy of phone and SMS follow-up care on patients' treatment adherence after coronary artery bypass graft.

Method. This clinical trial was performed on patients undergoing coronary artery bypass graft surgery in the heart surgery unit in Tehran hospitals in 2014. In this study, 90 patients were selected purposively and allocated into telephone follow-up group (n=30), SMS follow-up group (n=30) and control group (n=30). Demographic and treatment adherence questionnaire were completed twice (before intervention and two months after the intervention). The telephone follow-up and SMS follow-up groups were given training and booklet before discharge. In telephone follow-up intervention, three calls a week was made for two months and the SMS follow-up group received text messages daily for two months. To analyze the data, Chi-square test, Fisher exact test, t-test and ANOVA, ANCOVA, and Bonferroni test were used.

Findings. There was no statistically significant difference between the telephone follow-up and SMS follow-up groups in terms of treatment adherence scores, before and after intervention. A statistically significant difference was seen between telephone follow-up and control groups (p<0.0001), and SMS follow-up and control groups (p<0.0001) in terms of treatment adherence scores, before and after the intervention.

Conclusion. Both SMS and telephone follow-up are effective to improve treatment adherence in patients after coronary artery bypass graft. It is suggested to use these interventions for patient following coronary artery bypass graft.

Knowledge of critical care nurses of Tehran’s selected hospitals about arterial blood gas interpretation

Zahra Nezam Abadi

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.

The effect of passive range of motion exercise on motor function of patients in acute phase of stroke

Zahra Hosseini

Abstract

Aim. The study was conducted to examine the effect of passive range of motion exercises on motor function of patients in acute phase of stroke.

Background. Stroke is one of the most common cerebrovascular disorders. Continuous repetitive exercises in the first six month of stroke may restore significant part of sensory-motor function.

Method. In a randomized controlled trial, the patients with moderate or sever ischemic stroke who experienced hemiparesis or hemiplegia were recruited. Motor function level of defected limb was assessed based on “modified ashworth scale” and motor strength scoring tool. Patients in experimental group (n=37) received passive range of motion exercises, within the 48h of onset of stroke, 6-8 times with 30-45 minutes duration. Patients in control group (n=24) received conventional care. The groups were compared one month after intervention.

Findings. The most recovery was found in upper extremity strength after first month (3.45) relative to basic assessment (2.36). In experimental group, motor strength of upper and lower extremity improved, one month after intervention (P<0.0001). The results showed recovery in motor strength just in upper extremity of control group, after one month (P=0.012). Intervention had no effect on muscle tone.

Conclusion. According to more positive changes in motor function of experimental group after one month, it is suggested to apply the intervention for this group of patients.

The effect of music on anxiety of patients with heart failure

Hossein Salehzadeh

Abstract

Aim. This study aimed to examine the effect of music intervention on anxiety in patients with heart failure.

Background. Anxiety as a psychological problem can increase heart rate, respiration rate and blood pressure all of which have an advert effect on heart in patients with cardiovascular disease, particularly patients with heart failure.

Method. This controlled clinical trial study was conducted in Doctor Shariati Hospital affiliated to Tehran University of Medical Sciences. In this study, in each group (control, and music intervention), 25 hospitalized patients with heart failure were recruited through convenience sampling. Then, patients were allocated to groups by simple randomization. Data were collected by demographic characteristic form and Spiel Berger anxiety assessment questionnaire. In music group, music including two of the three types of classical, gentle and Iranian traditional music was played for 20 minutes after meeting for 3 sequential days by a tape recorder and headphone. Before and 15 minutes after intervention, patients' anxiety was measured and compared. Data was analyzed by using independent t-test, Paired t-test, Fisher’s exact test through SPSS.

Findings. There was a statistically significant difference between control and music intervention groups regarding anxiety score. Also, there was a statistically significant difference, before and after music intervention in anxiety score of patients with heart failure (p<0.0001).

Conclusion. The findings indicated that music intervention significantly reduces anxiety in patients with heart failure. Because of the importance of anxiety reduction in patients with heart failure, it is proposed that music intervention be used in the care of these patients.

The effect of pre-operative education on post-operative pain perception in patient undergoingCoronaryArteryBypass Graft

roghaye sadeghi

Abstract

Aim.The purpose of this study was to examine the effect of patient education on postoperative pain perception in patient undergoing Coronary Artery Bypass Graft (CABG).

Background.Pain is a common complication after CABG surgery. Non-pharmacological methods are more favorable than pharmacological agents.

Method.In this quasi-experimental study, 72 patients who were scheduled for elective CABG surgery were randomized to experimental (n=36) and control group (n=36). Experimental group received educational intervention about pain control, one day before surgery (20-30 minutes duration), while control group received no intervention. Following transferring to the ICU and 2 hours after extubation, patients’ pain intensity wasmeasured by Johnson’s numerical scale. The measurements wererepeated twice withanintervalof threehours. The type and dosage of pain medication administered during ICU stay were recorded. To analyse the data, descriptive(mean and standard deviation, frequency distribution and percentage) and analytical statistics (Chi-square and Mann-Whitneytest) were used.

Findings.There was no statistically significant difference between two groups in terms of demographic characteristics. Two hours after extubation, there were no statistically significant difference between experimental and control group in the intensity of pain (P=0.313). Pain intensity was significantly lower in experimental group than control group, 5 hours (P=0.015) and 8 hours (P=0.006) after surgery. The results also showedthat the amount ofanalgesics used to relieve post-operativepain was significantly lower in experimental group than control group (P=0.046).

Conclusion.Patient education about pain control may have positive effects on postoperative pain in patients undergoing CABG surgery. This intervention could serve as an effective strategy for nurses to improve pain management among these patients.

Effect of white noise on anxiety in patients admitted to the cardiac care unit

Azam Mahmoudi

Abstract

Aim.The purpose of this study was to examine the effect of white noise on the anxiety of patients in the Cardiac Care Unit (CCU).

Background. Many patients with cardiovascular disease suffer from some degree of anxiety after admission to CCU. Anxiety adversely affects patients' recovery.

Method.This was a quasi-experimental study conducted in ShaheedRajaei Cardiovascular Center, Tehran in 2014. Ninety patients admittedto the cardiac care unit were recruited in the study based on convenience sampling and divided into experimental and control group (45 patients in each group). Anxiety was measured in both groups for 2 consecutive days by DASS-21 questionnaire. In the experimental group, white noise with an intensity of 50 to 60 decibels was played for 30 minutes. Data were analyzed by SPSS , version 17, using independent t-test, paired t-test and chi-square test.

Findings. In control group, the difference between mean scores of anxiety, before and after intervention was not statistically significant (5.17±3.90 and 4.73±3.77, respectively p=0.08). In the experimental group, the difference between mean scores of anxiety, before and after intervention was statistically significant (5.38±3.87 and 4.58±3.71, respectively p=0.01).

Conclusion.The white noise can reduce the anxiety of patients admitted to CCU. This method can be used as a simple and low-cost non-pharmacological intervention for these patients.

A review of the role of diabetes in the development of atherosclerosis

Elham Navab

Abstract

Aim.This review study was done with the purpose of exploring the role of diabetes role in the development of atherosclerosis.

Background.The process of accumulation of fat in the blood vessels is called atherosclerosis. The most important risk factors and aggravating condition of atherosclerosis are the accumulation of carbohydrates and diabetes.

Method.In this study, we reviewed the electronic and manual searches of databases such as Medline, Embase, Springer, Blackwell Synergy, Elsevier, Scopus, Cochran Library and the databases SID, Iran Medex and Magiran within the time period of 2005 -2015.

Findings.The most common cause of death in patients with diabetes is coronary artery disease. Because nitric oxide production is higher in diabetic patients, the process of atherosclerosis occurs more rapidly and coagulation cascade disorder leads to the platelet adhesion, so, diabetic people, especially women, are more prone to atherosclerosis and coronary artery disease.

Conclusion.Nurses can modify several risk factors for atherosclerosis in these patients through education and follow-up, thereby, improving quality of life in these patients.