Cardiovascular Nursing Journal

Electrocardiogram changes among Iranian coal-mine workers

Sedigheh Khodabandeh-Shahraki

Abstract

Aim. This study investigated electrocardiogram changes among coal-Mine workers in Kerman, Iran.

Background. Chronic lung diseases such as pneumoconiosis, which cause air flow limitation are common among coal miners. Pneumoconiosis may results in heart disease and changes in the electrocardiogram. Due to the impact of pulmonary function on cardiovascular status, this index may show the risk of cardiovascular diseases in coal miners.

Method. This retrospective cohort study was conducted among 90 coal-mine workers in kerman as case group and 74 workers in the same mines who were not in contact with coal as controls between 2009-2013. The groups were matched in terms of age and work history. The inclusion criteria included age range of 30-45 years and work experience of at least 15 years. Individuals with a history of smoking, diabetes, obesity with a body mass index over 24, cardiac medications that caused ECG disorders and a history of systolic blood pressure above 120 mmHg were excluded from the study.

Findings. The mean age of the workers was between 32 and 46 with an average of 34.61 years. There was no statistically significant difference between groups in terms of age, weight and work history. Comparing electrocardiogram changes between the groups showed a statistically significant difference in the mean intervals of PR, QRS and QT in the leads D I, D II, and D III, with p≤0.0001, p≤0.01, and p≤0.001, respectively. ST segment interval was not significantly different between the groups.

Conclusion. Long term exposure to the coal may create electrocardiogram changes.

Comparison of clinical manifestations of acute coronary syndrome (ACS) in middle-aged and elderly people

Akbar Nikpajouh

Abstract
Aim.The aim of this study was to compare clinical manifestations of ACS in middle-aged and elderly people who were hospitalized in ShahidRajai Cardiovascular Medical and Research Center in 2016 .
Background. ACS is one of the most important health challenges in the world. The most important diagnostic marker of ACS is the clinical symptoms, but the symptoms of the disease are different among middle-aged and elderly people.
Method. This study was a cross-sectional study. The sample consisted of 384 patients with ACS admitted to ShahidRajai Cardiovascular Medical and Research Center in 2016. Data collection tools included demographics form, a questionnaire for recording signs and symptoms of ACS and the pain questionnaire. Data were analyzed in SPSS 18.
Findings. The most common symptom was chest pain in both groups. Typical symptoms between the two groups showed no statistically significant difference. Of non-typical symptoms, hiccup was reported more in middle-age group than the elderly group (P=0.001). In terms of the location of the pain, left arm in the elderly was higher than the middle-aged group (P=0.001). The quality of pain in both groups was not significantly different.
Conclusion. Chest pain is the most common symptom in both middle-aged and elderly people. Among the non-typical symptoms, only hiccups in the middle-aged people are more common than the elderly people. Health care providers should pay more attention to the initial assessment.

The effect of spiritual care on pain in patients undergoing coronary artery bypass grafting

Meysam Chahqui

Abstract
Aim. This research aims to investigate the effects of spiritual care on pain in patients undergoing coronary artery bypass grafting (CABG) surgery.
Background. Pain as a significant problem in patients undergoing CABG requires nursing care. Because of side effects from opioids, it is important to use non-pharmacological approaches such as spiritual care to control pain in these patients.
Method. This clinical trial was performed on 70 patients after CABG. Data collection tools included a demographic questionnaire, and McGill Pain questionnaire. The patients were randomly assigned into two groups of experimental and control. Spiritual care program in the experimental group included supportive presence, supporting patient’s rituals, and using supportive systems for 3 days. Pain levels were measured before and after intervention for both groups. The control group did not receive any intervention. Data were analyzed in SPSS version 20.
Findings. There was no statistically significant difference between the two groups in terms of in demographic characteristics. Before intervention, no statistically significant difference was found between the pain scores of the groups, however, after the intervention, pain scores were significantly lower in the experimental group than in the control group. There was also a statistically significant difference between the pain scores of the experiment group before and after the intervention. Such a difference was not found in the control group.
Conclusion. Spiritual care program reduced pain in patients undergoing CABG. With regard to the results of the present study, it is suggested that nurses include religious-spiritual care in nursing care plan as a helpful way to control pain in these patients.

The effect of education on quality of life in people with unstable angina

Mohammadreza Razm-Ara

Abstract
Aim. This study was conducted to determine the effect of education on quality of life in people with unstable angina in Qa'en, Iran.
Background. Cardiovascular diseases are the most prevalent and important cause of death all over the world, which affect the patients' quality of life. These diseases create many problems for patients and a lot of cost for the society.
Methods. This study was an experimental study with pretest-posttest design and control group which was conducted on 60 patients in the cardiac care unit Shohada hospital located in the city Qaen, Iran in 2015. The recruited patients were divided randomly into control and intervention group. During 3-6 sessions of face-to-face training (1-2 sessions per day) lasting between 15-20 minutes, screenshots (in PowerPoint software) were used and the participants questions were abswered. The quality of life of the patients in both groups were measured at two stages, before education (for intervention group) and one month later. The instruments were demographic and quality of life questionnaires (SF36). Data were analyzed in SPSS, version 20.
Findings. There were a statistically significant difference between the groups in terms of the mean scores of quality of life in the following dimensions: general health (p=0.02), physical function (p=0.003), role limitation due to physical health (p=0.05), energy fatigue (p=0.01), emotional well-being (0.004), pain (p=0.007), and total quality of life (p=0.02) .
Conclusion. Education can be a useful method for improving quality of life in people with unstable angina patients.

Relationship between lifestyle and cardiac self efficacy among people with heart failure

sima babaei

Abstract
Aim.This study aimed to determine the relationship between lifestyle and cardiac self efficacy among people with heart failure.
Background. As a common disease, heart failure is a major cause of death and disability in the world. In the treatment of heart failure patients, there is a special emphasis on lifestyle modification. In order to improve the lifestyle of patients with heart failure, cognitive-behavioural factors such as cardiac self-efficacy can be considered.
Method. This descriptive correlational study was conducted on 227 patients with heart failure referred to cardiology clinics of hospitals affiliated to Isfahan University of Medical Sciences. The data gathering tool consisted of three sections: demographic form, Sullivan's cardiac self efficacy questionnaire and health-promoting lifestyle profile. The data were analysed in SPSS, version 16.
Findings.The mean score of cardiac self-efficacy was 58.45±25.92 and the mean score of total lifestyle was reported 54.45±16.27. A statistically significant direct relationship was found between the mean score of total lifestyle and the mean score of cardiac self-efficacy (r=0.463, p≤0.0001). The Pearson correlation coefficients showed a direct correlation between the scores of all dimensions of lifestyle and score of cardiac self-efficacy (In all cases, p≤0.0001).
Conclusion: There is a positive and significant correlation between lifestyle and cardiac self efficacy of patients with heart failure.

Knowledge, attitude, and practice of nurses about self-care education for people with chronic heart failure

Pari Karami

Abstract
Aim.This study was conducted to investigate the level of nurses’ knowledge, attitude and practice about self-care education in people with heart failure.
Background.Heart failure is one of the most common chronic diseases and the leading cause of death in the world and also, a major cause of hospital readmission, especiallyin elderly patients. Self-care education is an essential componentof care for people with heart failure. Nurses are the first providers ofself-careeducation for patients and must have a thorough knowledge, a positive attitude and skillfull practice in the field of self-care education.
Method. In this descriptive-analytical study, 174 nurses with at least one year working experience in the CCU, post CCU and medical wards of ShahidRajaie Cardiovascular and Research Center, completed a four-part questionnaire including demographics information, and knowledge, attitude and practice about self-care education in people with heart failure. Data were analyzed using descriptive and inferential statistics in SPSS, version 22.
Findings. The majority of nurses (70.1 percent) had an average knowledge score. The knowledge level of nurses were significantly related with level of education and working experience. Also, 67.8 percent of the participants had a good practice of self-care education about heart failure and their practice was significantly related with experiencing in-service education. More than 90 percent of nurses reported positive attitude towards self-care education about heart failure and their attitude was significantly related with level of education, in-service education and work schedule.
Conclusion. The knowledge of nurses was at average level. It is recommended to plan in-service education in order to promote nurses’ level of knowledge about self-care education about heart failure.

Perspective of nurses’ role in echocardiography

Ali Hosseinsabet

Abstract
Aim. This review study was conducted to identify perspective of nurses’ role in echocardiography.
Background. Joining nurses to the echocardiography team in 1980s led to advancement and broadcasting of echocardiography. Taking care of the patient is of nurses duties, so preparing the patient before diagnostic modalities such as trans-esophageal echocardiography and stress echocardiography are among their duties. There is an increasing tendency by nurses to have more roles in echocardiography.
Method. This review was conducted by searching out databases PubMed and Scopus by the keywords “nurse”, “echocardiography” and “cardiac ultrasound” and related articles published up to July 2017 were considered.
Findings. Nowadays, nurses perform their roles in the field of echocardiography in critical care wards, outpatient ward and at the time of screening for cardiovascular diseases.
Conclusion. Short courses of echocardiography with focus of point are valid and possible. It provides the possibility of best patients’ care.

The role of ECMO in the management of pulmonary barotrauma in people with decompression sickness: Literature review

Zahra Abbasi Dolatabadi

Abstract
Aim. This literature review investigates the role of ECMO in the management of pulmonary barotrauma in people with decompression sickness (DCS).
Background. As a result of change in the atmospheric pressure in sea depth, divers may experience life threatening conditions such as barotrauma in vital organs including the lungs. Delivering 100% oxygen is the immediate treatment in these situations. A modern technology for oxygen therapy and supporting vital organs in heart and lung failure is extracorporeal membrane oxygenation (ECMO).
Method. This review was conducted by searching out databases UpToDate, Google scholar, Elsevier, SID and Magiran between 1995-2016 by the following keywords: diver, diving, decompression sickness, decompression syndrome, lung injuries, respiratory disorders, pulmonary barotrauma, treatment, and ECMO, and their Persian equivalents.
Findings. Oxygen administration and prevention of severe complications caused by accumulation of nitrogen bubbles in the body is an important treatment in this DCS. Oxygenation by nasal cannula in early stage and hyperbaric oxygenation in sever conditions are common treatments. ECMO can remove nitrogen bubbles of the blood and body and decrease concentration of nitrogen in the blood, and furthermore, improves oxygenation.
Conclusion. To rescue and prevent death in DCS victims, it is required to consider appropriate measures by minimum side effects. To do so, veno-venous ECMO can be a safe technique. The studies conducted in this field are limited; therefore more studies about ECMO usage in DCS must be conducted.