Cardiovascular Nursing Journal

Sharp instruments injuries in intensive and general wards

Reza Shahrabadi

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.

Comparative study on quality of life in patients after Percutaneous TransluminalCoronary Angioplasty and Coronary Artery Bypass Graftsurgery

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.

Perception of patients with cardiovascular disease about barriers and benefits of health promotion behaviors

Sharareh Zeighami Mohammadi

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.

The Effect of Anti-Embolism stocking in preventing lower limb edema following saphenous vein harvesting in patients undergoing coronary artery bypass graft surgery

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.

The effect of cardiac rehabilitation care plan on the quality of life in patients undergoing coronary artery bypass graft surgery

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.

Prevalence of cardiovascular disease risk factors among the Sharif University of Technology students

Majid Gholipour

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.