Cardiovascular Nursing Journal

Knowledge and attitude of Isfahan people about prevention of cardiovascular disease

Ladan Naseh

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.

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

Shahnaz Pooladi

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.

Relationship of self-care behaviors with hospital readmission in people with heart failure

Masumeh Hemmati-Maslakpak

Abstract
Aim. This study aimed to determine the relationship between self-care behaviors and readmission in people with heart failure.
Background. People with heart failure are frequently hospitalized due to worsening symptoms. Admission to hospital reduces quality of life of patients, also imposes large costs for them. To control this disease, adherence to self-care behaviors is important.
Method. In this descriptive analytical study, 245 heart failure patients with the history of readmission were recruited with convenience sampling method from Taleghani and Syedalshohada teaching hospitals of Urmia, in 2016. Data collection tool included self-care heart failure Index. Data were analyzed by descriptive and inferential statistics using SPSS.
Findings. Self-care mean score in participants was 45.59±7.6 and most patients had a moderate level of self-care behaviors. Pearson correlation coefficient showed a reverse statistically significant correlation between self-care score with the number of hospitalization (r=-223, p≤0.0001).
Conclusion. Self-care behaviors of the majority of patients was not favorable in terms of quality and there was a reverse correlation between self-care behaviors and readmission, It is suggested further investigating the factors affecting self-care behaviors and taking actions to deal with these factors.

The effect of participation-based education program on knowledge and practice of critical care nurses about central venous catheter care

Meysam Nematikhah

Abstract
Aim. This study aimed to examine the effect of participation-based education program on nurses' knowledge and practice of critical care nurses about central venous catheter care in intensive care units in teaching hospitals of Zanjan University of Medical Sciences, Iran.
Background. Improving the quality care of central venous catheters requires the promotion of nurses’ knowledge of standard guidelines and manuals of catheter care and also the knowledge of latest findings in this field.
Method. In this quasi-experimental study with pretest-posttest design, 46 nurses working in intense care unit of two teaching hospitals (Ayatollah Mousavi and Vali-e-Asr hospital) were recruited into experimental group (n=28) and control group (n=18). Before intervention, nurses' knowledge and performance regarding central venous catheter care were measured by the questionnaire developed by Labio et al. in 2008 and a researcher-made observational checklist. Then, educational intervention based on participation was implemented for the experimental group for 1 month, and routine intervention (taking part in one session lecture) was also carried out for the control group. Three months after intervention, nurses' knowledge and performance were measured again through questionnaire and checklist by the co-researcher. Data were analyzed by SPSS (version 16) utilizing Chi-square, Fisher, ANOVA, and independent t-test and paired-sample t- test.
Findings. After intervention, there was a statistically significant difference between experimental and control group in mean change of knowledge score (experimental group, 2.82 against control group, 1.67)(p=0.004) and performance score (experimental group, 11.69 against control group, 10.85) (p≤0.0001) about central venous catheter care.
Conclusion. Educational intervention based on participation is more effective than the other conventional retraining programs in improving the nurses' knowledge and performance about central venous catheter care. It is suggested to apply participation-based education program for in-service training.

Effectiveness of Mindfulness-Based Stress Reduction (MBSR) on depression and anxiety of people with coronary artery disease after coronary artery bypass graft surgery

Rasoul Heshmati

Abstract
Aim. The aim of this study was to examine the effect of Mindfulness-Based Stress Reduction (MBSR) on depression and anxiety in people with coronary artery disease (CAD) treated with coronary artery bypass graft (CABG) surgery.
Background. Depression and anxiety are common in people with CAD treated with CABG. Therefore, it is important to investigate if effective therapeutic models can influence the negative emotions of these patients.
Method. The research method was single-subject and the statistical population of this study included all people with coronary artery disease who referred to Shahid Madani Hospital in Tabriz, Iran, during the second six months of the year 2016 for rehabilitation after surgery. The study sample consisted of four available people with CAD who received eight sessions of MBSR training by the researcher. The subjects were assessed before and after receiving the MBSR training by Beck Depression Inventory, and Beck anxiety Inventory. The data were analyzed through recovery percentage, percent of non-overlapping data (PND), standardized mean difference (SMD) and visual analysis of the charts.
Findings. The findings showed that MBSR training reduced anxiety and depression in people with CAD following treatment with CABG.
Conclusion. Based on these findings, it be can concluded that MBSR is an effective treatment for management of negative emotions of people with CAD treated with CABG.

The effect of changing position on back pain after cardiac catheterization

Afsaneh Kojaie-Bidgoli

Abstract
Aim. The aim of this study was to examine the effect of changing position on back pain after cardiac catheterization.
Background. Prolonged bed rest after coronary angiography produces back pain.
Methods. This was a quasi-experimental study conducted on 98 patients who had been admitted for coronary angiography in Shahid Beheshti Hospital of Kashan, Iran, in the year 2014. Patients were randomly allocated to intervention and control group. In this study, data collection form consisted of three sections including demographic information, numerical pain scale, and bleeding and hematoma control checklist. Patients in the control group received routine care after coronary angiography including bed rest for 6 hours without movement of effected limb. However, patients’ position in the intervention group was intermittently changed during the first 6 hours after catheterization. Patients in the intervention and control group were assessed in terms of severity of pain, and bleeding and hematoma, immediately after moving to the ward, and then two, four and six hours after angiography. The data were analyzed in SPSS version 11.5 using descriptive and inferential statistics.
Findings. The result showed that there were statistically significant differences between the intervention and control group in terms of mean score of back pain immediately after moving to the ward (p≤0.0001), and 4 hours (p≤0.0001) and 6 hours (p≤0.0001) after angiography.
Conclusion. In this study, changing position of patients after angiography reduced back pain in patients without causing any complication like hematoma and bleeding; therefore, it can be concluded that applying this intervention could be considered as a convenient way to relieve back pain in patients after coronary angiography.

Drug updates for prevention and treatment of venous thromboembolism in orthopedic surgeries

Zahra Abbasi Dolatabadi

Abstract
Aim. The purpose of this study is to review new achievements in prevention and treatment of venous thromboembolism (VTE) in orthopedic surgeries.
Background.
Method. This is a comprehensive review of literature published between 1998-2017 about prevention and treatment of VTE in orthopedic surgeries that was conducted through searching scientific databases and search engines Ovid, Science Direct, Medline, Google Scholar, and PubMed using the English and Persian forms of the words Apixaban, Dabigatran, Heparin, orthopedic procedures, venous thromboembolism, and Fondaparinux. In total, 35 English papers and 10 Persian papers were found, out of which 25 papers were included in the review.
Findings. The risk of VTE is increased considerably during orthopedic surgeries. It is associated with important morbidities and also can increase mortality rate. Without prophylaxis, there is a noticeably increased risk of both venous and pulmonary embolism. Choosing a prophylactic pharmacologic agent depends on its efficacy and safety and also, on the presence of comorbidities and patient preferences.
Conclusion. The features of primary preferred primary prophylactic method is easy management safety, effectiveness with limited or no need for laboratory observation, and cost effectiveness. The use of prophylactic anticoagulation in patient undergoing major orthopedic surgeries considerably reduces the risk of VTE, but does not completely exclude it.

Cardiac arrhythmias in people with subarachnoid hemorrhage

Zahrasadat Hoseini

Abstract
Aim. This review aimed to explore the issue of cardiac arrhythmias in people with subarachnoid hemorrhage.
Background. Intracranial injuries may cause cardiac arrhythmia and structural changes. Between 25-90% of patients with subarachnoid hemorrhage experience cardiac arrhythmia. In case of inappropriate diagnosis, unnecessary workup and treatment may be done.
Method. The studies published between 2000 and 2017 were searched for in databases and search engines Google Scholar, Pumped, Science Direct, Magiran, and SID by the keywords electrocardiogram, arrhythmia, ECG abnormalities, intracranial hemorrhage, subarachnoid hemorrhage and their Persian equals.
Findings. Provoking the autoimmune system by stimulating the hypothalamus and increasing the circulating catecholamines in patients with cerebrovascular bleeding are two significant mechanisms responsible for cardiac arrhythmias and myocardial damage.
Conclusion. The timely diagnosis of electrocardiographic changes in patients with cerebral hemorrhage is one of the effective factors in determining the prognosis and deterioration of clinical status. It seems that taking the exact medical history, recording ECG at the time of patient admission, and diagnosing the cerebral hemorrhage, in particular subarachnoid hemorrhage, are necessary measures in the health care centers.