Cardiovascular Nursing Journal

The effect of education based on Orem’s self-care model on emotional reactions in patients with Implantable Cardioverter Defibrillator (ICD)

Samaneh Parchebafieh

Abstract
Aim. The purpose of this study was to examine the effect of education based on Orem’s self-care model on emotional reactions in people with Implantable Cardioverter Defibrillator (ICD).
Background. ICD shock is unpredictable and associated with physical pain. After receiving shock, some patients find serious psychological problems such as anxiety, depression and stress. According to Orem, learning self-care activities can help a person to maintain health and well-being and increase the ability to adapt to illness.
Method. In this quasi-experimental study, 60 people with ICD who were admitted to Shahid Rajaie Cardiovascular Medical and Research Center in Tehran, were recruited. The data collection tool was a demographic form and DASS-21 questionnaire. The educational program based on Orem’s self-care model was performed in 3 sessions of 20-30 minutes based on individual self-care needs of the participants. Emotional responses were measured in two stages, before and one month after the end of intervention. Data were analyzed using SPSS software version 22.
Findings. Before intervention, the mean score for anxiety was 18.06±5.49 that decreased after intervention (11.26±3.49) (p≤0.0001). The mean score of depression was significantly decreased after intervention (10.78±3.91 against 16.28±5.96; (p≤0.0001). Before intervention, the mean score for stress was 23.58±6.17 that decreased after intervention (15.51±4.18) (p≤0.0001).
Conclusion. Application of Orem’s self-care model can be effective in reducing the intensity of emotional reactions in people with ICD. Nurses can play a role in reducing emotional reactions by implementing this model and assessing educational needs of patients.

The effect of cognitive-behavioral rehabilitation based on stress immunization training on anxiety, stress and depression in people with coronary artery bypass graft surgery (CABG)

Fateme Nequee

Abstract
Aim. This study was conducted to determine the effect of cognitive-behavioral rehabilitation based on stress immunization training on anxiety, stress and depression in patients with coronary artery bypass graft surgery.
Background. Stress, anxiety and depression that play an important role in coronary artery disorders, are being considered as a hindrance to recovery after CABG. Providing the patient with correct coping strategies with stress seems to be helpful in preventing the recurrence.
Method. The study was a quasi-experimental with control group with pretest-posttest design. The statistical population of this study included patients who had coronary artery bypass graft surgery and referred to the Rehabilitation center of Tehran Heart Hospital, Tehran, Iran. Thirty subjects were selected by continuous sampling method and randomly assigned into experimental and control group. The instruments for data collection were “Depression, Anxiety and Stress Scale” (DASS-21), which completed before and after the intervention. The experimental group was exposed to stress immunization training in 10 sessions of 90 minutes. To analyze the data, multivariate covariance analysis, and one-variable covariance analysis were used in SPSS software.
Findings. Stress immunization training significantly influenced the anxiety (p≤0.0001; F=0.39), stress (p≤0.0001; F=0.35), and depression (p≤0.0001; F=0.68) scores of the experimental group compared to the control group.
Conclusion. Stress immunization training plays an important role in reducing negative emotions (anxiety, stress and depression) in patients with coronary artery bypass graft surgery. It is recommended to use this intervention for patients undergoing CABG.

The effect of peer education on the anxiety - of post Coronary Artery Bypass Graft patients and caregivers in Rajaee Cardiovascular Medical and Reseach Center

Sadegh Heydarpoor

Abstract
Aim. The purpose of this study was to examine the effect of peer education on the anxiety - of post Coronary Artery Bypass Graft patients and caregivers
Background. Patients undergoing coronary artery bypass surgery experience moderate to high anxiety, which has also been reported among their family members. Studies have shown that educating patients and their family caregivers has in many cases reduced their anxiety. Peer education and research on the effect of peers is of great importance in promoting therapeutic and caring goals.
Method. This randomized clinical trial study was performed in year 2018 in surgery wards of Rajaee Cardiovascular Medical and Research center. In this study, 60 family caregivers of patients undergoing coronary artery bypass graft surgery and their respective patients were recruited at the time of discharge from intensive care unit and entering into the surgical ward. The subjects were randomly assigned to experimental and control group. Data collection tools included demographic information questionnaire and Spielberger's "State and trait anxiety" form. Initially, patients' family caregivers who were selected as peers were trained by the researcher in three stages. Before visiting the patients by family caregivers, their anxiety and also, patients' anxiety was measured in both groups. Thereafter, the patients’ family caregivers in the control group received routine training, and the patients' family caregivers in the experimental group received peer training in two sessions by their peers. In the third step, the anxiety of patients and their family caregivers in both groups were measured on the second and fifth days after intervention. The data were analyzed in SPSS 20 software.
Findings. Before intervention, the mean scores of anxiety in the experimental and control groups were not statistically different in both patients and their family caregivers, and the mean anxiety scores in both groups were moderate to high. After intervention, the mean score of anxiety in the experimental group was significantly lower than the control group (P≤0.0001). Also, in the second and fifth days after the intervention, there was a significant difference between the experimental and control groups in the mean score of anxiety of the patients and their family caregivers (P≤0.0001).
Conclusion. Peer education seems to reduce anxiety in patients and their family caregivers after discharge from ICU. It is suggested that peer education be used as effective and low cost education to reduce patient and family caregiver anxiety.

Effect of Teach Back Learning Strategy on Perceived Diseases, Nutritional Knowledge and Follow-up of Diet in Hypertension Patients

Malihe Davoudi

Abstract
Aim. The aim of this study was to examine the effect of teach back learning strategy on illness perception, nutritional knowledge and dietary adherence in people with hypertension.
Background. Because of the chronicity of hypertension and the importance of nutrition in hypertension control, illness perception and nutritional knowledge play an important role in adherence to nutritional regimen and disease control.
Method. The present study is a quasi-experimental study control group and pretest-posttest design. Based on random sampling, two health care centers in Ferdows were selected as the place for experimental and control group. Using a simple randomized method, of patients with hypertension, 35 individuals were recruited for each group. These people entered the study based on inclusion criteria and after that they signed the consent form. Before and after the intervention, illness perception, nutritional knowledge and dietary adherence were measured by self-report questionnaire and compared between the groups.
Findings. After intervention, the mean score of nutritional knowledge in experimental and control group was 48.17±5.21 and 41.16±0.51, respectively, and a statically significant difference was found between groups in terms of nutritional knowledge (P≤0.0001; t=9.56). After intervention, the mean score of illness perception in experimental and control group was 9.75±1.81 and 7.72±1.60, respectively, and there was a statically significant difference between groups in terms of illness perception (P≤0.0001; t=4.15). But no statically significant difference was found between experimental and control group in terms of dietary adherence (17.55±4.17 against 16.88±3.62).
Conclusion. Given the positive effects of teach back method and the special role of nurses in patient education, attention to this teaching method seems necessary. The use of this method of training is suggested as part of care process to reduce patients' clinical problems.

The effect of bed angle on back pain, urinary retention and vascular complications after coronary angiography

Maasoumeh Barkhordari Sharifabad

Abstract
Aim. The purpose of this study was to examine the effect of bed angle on back pain, urinary retention and vascular complications after coronary angiography.
Background. To minimize the severity of low back pain and urine retention after angiography, modalities such as changing position, changing bed angle, and early out of bed have been used, but there is still controversy about the appropriate bed angle that reduces cardiovascular complications and at the same time provides patient comfort.
Method. This study was a randomized clinical trial conducted on 120 patients after angiography in cardiology and angiography wards of Shahid Sadoughi Hospital, Yazd, Iran, in 2018. A total of 120 patients who were candidates for angiography were randomly divided into control and experimental group. After angiography, for the control group, the bed angle was zero, and for the experimental group, the bed angle was set at 30 degrees, from entry to the ward for 4 hours. Data collection tools included demographic and clinical information questionnaire, numerical scale for measuring severity of pain, hematoma and hemorrhage recording form and urinary retention observation and recording form. Data analysis was performed in SPSS Version 20 using descriptive and inferential statistics.

Findings. The mean score of back pain in the experimental group, immediately and four hours after angiography was 0.166±0.767 and 0.216±55.0, respectively, which was lower than that of control group (0.233±0.615 and 0.433±0.927, respectively), but the difference was not statistically significant. Also, there was no statistically significant difference between groups in terms of urinary retention, immediately and 2 hours after angiography. There was no statistically significant difference between groups in terms of vascular complications (hematoma and hemorrhage).

Conclusion. The results of this study did not show any evidence that 30 degrees bed angle adjustment have any different effect on pain severity, urinary retention, and vascular complications of the zero degree bed angle. It is recommended that after angiography, the angle of the bed be set to zero or 30 degrees according to the patient's comfort and preference.

Relationship between critical care nurses occupational stress and their child anxiety

narges sadeghi

Absrtact

Aim. The aim of this study was to determine the relationship between critical care nurses’ occupational stress and their child anxiety in Shahid Rahimi Hospital in Khoramabad City, Iran, in 2017.

Background. Work-family conflict is the source of stress that most people, especially nurses experience and its consequences can also affect family members.

Method. This study is a cross-sectional analytical study in which all critical care nurses (n=150) in Shahid Rahimi Hospital in Khoramabad City, Iran, were recruited using census sampling method and based on inclusion criteria. To collect data, a demographic form, Spence Children’s Anxiety Scale (SCAS)-Parent Version, and Nurses Stress Scale were used. Data analysis was conducted SPSS 19 using descriptive and inferential statistics.

Findings. The average scores of nurses’ stress and child anxiety were 75.61±14.98 and 77.04±11.14, respectively. Pearson Correlation Coefficient showed the relationship between critical care nurses job stress and child anxiety (p=0.008, r=0.214).

Conclusion. Critical care nurses' job stress increases the anxiety of their children. Therefore, providing some programs for reducing nurses’ job stress is recommended.

Effective factors on outcomes of heart failure disease: a review article

Masoumeh Zakeri Moghaddam

Abstract
Aim. The aim of this study was to identify the factors affecting the outcomes in people with heart failure.
Background. Heart failure is a complex clinical syndrome. Due to functional and structural problems occurs in the heart failure and its high prevalence and associated financial burden, it is considered a public health problem. Mortality rate and serious complications from the disease are on the rise. Decreased quality of life and frequent hospitalizations are among these complications.
Method. In this review study, a comprehensive search on scientific databases and search engines such as Science Direct, Ovid, PubMed, Google Scholar, Medline was conducted with the keywords heart failure, education, health literacy education, heart failure knowledge, self care, readmission, family support and heart failure outcomes for papers published between 2003 to 2018.
Findings. Heart failure is associated with many problems and several factors affect the patient. Focusing on previous studies on factors influencing the outcomes of heart failure, we can refer to patient health literacy, self-care, heart failure knowledge and patient family support. Education of affected patients has also influenced the outcomes of the disease and frequent hospitalization of patients.
Conclusion. Patient education based on health literacy has effect on heart failure outcomes.

Impact of door-to-ECG time on morbidity and mortality of patients with chest pain referred to emergency department

Masoumeh Zakeri Moghaddam

Abstract
Aim. This review study aims to investigate the impact of reducing Door-to-ECG (DTE) time on on morbidity and mortality of patients with chest pain referred to emergency department.
Background. Chest pain is the second most common reason for referral to an emergency unit. According to American Heart Association, all patients with chest pain presenting to the emergency ward should be approached with an ECG within 10 minutes of entrance to the emergency department. This is considered as the first line of diagnostic tests for myocardial infarction.
Method. In this narrative review study, several databases and search engines including SID, Pub Med, Google Scholar, Web of Science and Scopus were used to find the articles published between 2000 and 2018. The keywords used to search articles were “Door to ECG”, “chest pain”, “emergency unit” and “triage”. The articles selected for review were interventional or descriptive in terms of design, in Persian or English, with available full text. The criterion for selecting articles was the similarity of the their subject with the search keywords including Door to ECG (DTE) time and triage and their value in the early diagnosis and treatment of coronary disorders.
Findings. A total of 20 articles were found. After removing the articles that didn’t meet the inclusion criteria, 11 articles related to the subject of the study remained in review. The significant outcomes of timely triage, appropriate time to perform ECG, barriers to access and suggestions for faster treatment by the system especially the role of nurses, were investigated.
Conclusion. The reduction of triage time and Door to ECG (DTE) time as well as the role of the nurse in those cases are associated with a reduction in the morbidity and mortality of cardiac patients.