Cardiovascular Nursing Journal

The effect of cognitive-behavioral therapy on depression, anxiety and stress in patients after coronary artery bypass graft surgery

Saeed Moosavipour

Abstract
Aim. The aim of this study was to examine the effect of cognitive-behavioral therapy on depression, anxiety, and stress in patients after coronary artery bypass graft surgery.
Background. Coronary artery bypass graft surgery, like other surgeries, is stressful for the patient, and depression, anxiety, and stress are common important disorders in these patients. In this regard, one of the effective psychotherapy methods to reduce negative psychological factors and prevent recurrence of the disease is cognitive-behavioral therapy.
Method. The design of the present study was quasi-experimental with a pretest-posttest design with a control group. The statistical population of the study included all patients after coronary artery bypass graft surgery in selected AJA hospital in Tehran, Iran. Based on convenience sampling, 30 people were selected and randomly allocated to experimental (n=15) and control (n=15) group. They responded to the Depression, Anxiety and Stress Questionnaire (DASS-21) and underwent 15 sessions of psychotherapy. The experimental and control group were homogeneous in terms of age, education, as well as duration of hospital stay and absence of other chronic diseases. The univariate analysis of covariance was performed using SPSS-23.
Findings. The results showed that depression, anxiety and stress of the experimental group significantly reduced in the post-test compared to those of control group.
Conclusion. In addition to medical interventions, cognitive-behavioral therapy can also be used for patients after coronary artery bypass graft surgery to reduce depression, anxiety and stress and prevent recurrence of the disease. Special attention can also be paid to the psychological factors that cause or exacerbate cardiovascular disease.

The effect of family-centered self-care program on the activity of people with cardiovascular disease after hospital discharge

Esmaeil Mohammadnejad

Abstract
Aim. The purpose of this study is to review studies that have investigated the effect of family-centered self-care program on the activity of people with cardiovascular disease after hospital discharge.
Background. Adherence to medication, diet and physical activity in people with cardiovascular disease is very crucial to prevent readmission, independence in daily activities, and complications.
Method. In this review study, a comprehensive search of scientific databases and search engines such as Science Direct, Scopus, PubMed, Google Scholar, and Medline using the keywords cardiovascular disease, adherence to treatment regimen, and family-centered self-care program in both Persian and English languages was done to find articles published between 2000 and 2020.
Findings. Family-centered post-discharge self-care program can be a principled and effective method to increase adherence to medication, diet and physical activity in heart people with cardiovascular disease.
Conclusion. One of the most important factors in effectiveness of self-care is active family participation and family-centered self-care, which can be effective in three areas after the discharge of people with cardiovascular disease.

The effect of functional analytical psychotherapy on treatment adherence and self-care behaviors in female patients with acute myocardial infarction

Alireza Sangani

Abstract
Aim. The aim of this study was to examine the effect of functional analytical psychotherapy on treatment adherence and self-care behaviors in female patients with acute myocardial infarction.
Background. The severity of cardiovascular disease is affected by cognitive and behavioral function in people experiencing acute myocardial infarction. Therefore, with effective and modern treatments for this problem, effective results could be expected.
Method. The research method was quasi-experimental pre-test post-test and follow-up design with control group. A sample of 30 women with a history of acute myocardial infarction who had been admitted to Seyed Al-Shohada Heart Hospital in Urmia, Iran, in 2021, were selected based on inclusion and exclusion criteria and randomly assigned to experimental (N=15) and control (N=15) group. Tsai et al. (2010) Functional Analytical Psychotherapy Package was implemented for experimental group in 10 sessions of 45 minutes duration. Before and after the sessions, and also, 3 months after intervention, both members of experimental and control groups completed Treatment Adherence Questionnaire and Self-Care Behavior Questionnaire as pre-test, post-test and follow-up measurements. Data were analyzed using mixed model analysis of covariance in SPSS Version 18.
Findings. The results showed that there was a statistically significant difference between experimental and control groups in term of the means of treatment adherence and self-care behaviors in pre-test, post-test and follow-up. Functional analytical psychotherapy had a greater effect on improving self-care behaviors (0.912) than treatment adherence (0.897) in female patients with acute myocardial infarction (P≥0.0001).
Conclusion. These results emphasize the effect of functional analytical psychotherapy in cognitive and behavioral domains in the treatment of female patients with acute myocardial infarction.

Attitudes of intensive care unit nurses towards communicating with patients unable to speak

Masoomeh Imanipour

Abstract
Aim. The aim of this study was to determine the attitudes of intensive care unit nurses towards communicating with unconscious or conscious intubated patients unable to speak.
Background. Communication is one of the most important tools in patient care and is more important in intensive care units because many patients are unable to communicate verbally due to illness or treatment.
Methods. This descriptive cross-sectional study was conducted on 174 nurses working in intensive care units. They were selected by convenience sampling method. Data were collected by a researcher-made questionnaire through self-report. This questionnaire had two sections of views on communication with unconscious or conscious intubated patients unable to talk and factors related to non-communication with these patients which was completed either in paper or electronic form. The data were analyzed in SPSS version 26 using descriptive statistics and Pearson correlation.
Findings. The results showed that the majority of the studied units (94.3 percent) had a positive attitude towards communicating with patients with speech disabilities admitted to intensive care units. It was also found that large number of patients, nurse's reluctance to work in intensive care units, loading of unprofessional tasks, psychological fatigue, and no mastery in communicative skills are more associated with communicating with this group of patients.
Conclusion. According to the positive attitude of nurses towards communicating with unconscious or conscious intubated patients unable to speak, this positive attitude can be used to improve nurses' communication performance. In addition, it is necessary to improve the quality and quantity of communication with patients with speech problems through management measures to control some factors related to communicating with patients with speech impediments.

Comparison of the effect of schema therapy and dialectical behavior therapy on lifestyle of women with coronary artery heart disease

Ahmad Karbalaei Mohammad Migooni

Abstract
Aim. The present study aimed to compare the effect of schema therapy and dialectical behavior therapy on lifestyle of women with coronary artery heart disease.
Background. Given that an unhealthy lifestyle is one of the main determinants of early onset of coronary heart disease in adulthood and its resulting mortality, the need for therapeutic interventions in this group of patients seems necessary.
Method. This experimental study (pre-test-post-test with control group and follow-up) was conducted on women with coronary heart disease in Tehran in 2019-2020. A total of 45 female patients were selected by available sampling method and randomly allocated to two experimental group and one control group (15 people in each group). Experimental and control groups were assessed during the pre-test, post-test and one-month follow-up stages by Lali et al. (2012) lifestyle questionnaire. Eight sessions of group schema therapy (for one experimental group) and eight sessions of group dialectical behavior therapy (for another experimental group) were held (two sessions per week for 4 weeks). The data were analyzed using repeated measures analysis of variance in SPSS V.23.
Findings. Both interventions were effective in promoting lifestyle in women with coronary heart disease (p≤0.0001). Also, group dialectical behavior therapy had a greater effect on lifestyle promotion in women with coronary heart disease compared with group schema therapy (p≤0.0001).
Conclusion. Training of the use of group dialectical behavior therapy is recommended as an effective intervention method for improving lifestyle of women with coronary heart disease.

The relationship between biomarkers and the severity of coronary artery disease: The moderating role of affective temperament

Mohammad -Ali Besharat

Abstract
Aim. The aim of this study was to determine the moderating role of affective temperament in the relationship between biomarkers (troponin, white blood cell count, and neutrophil to lymphocyte ratio) and the severity of coronary artery disease.
Background. Coronary artery disease is the leading cause of death among adults worldwide and is considered as an inflammatory disease. Recent studies, in addition to biological factors, have focused on the role of psychological factors in the incidence and severity of this disease.
Method. In this study, 200 patients (145 males, 55 females) with coronary artery disease admitted to Shahid Rajaei Hospital in Tehran in 2018-2019 were selected by continuous sampling. Participants were asked to complete the positive and negative affectivity scale (Besharat, 2014). Also, the number of biomarkers was assessed through blood tests and the number of involved vessels was assessed through angiography and diagnosis by a specialist physician.
Findings. The results of hierarchical multiple regression showed that in the first step, 62 percent of the variance of coronary artery disease was predicted by biomarkers, and by entering the interaction between predictor variables (severity of coronary artery disease) and moderating variables (positive affectivity and negative affectivity), explanation of variance of the coronary artery disease increased by 9 percent and reached to 71 percent.
Conclusion. Based on the findings of the study, affective temperament affects the relationship between biomarkers and the severity of coronary artery disease, and therefore, as a psychological factor, could plays an important role in preventing coronary artery disease and decrease the number of deaths and the annual cost of this disease.

Comparison of the effectiveness of acceptance and commitment-based therapy and emotion-focused cognitive therapy on psychological well-being of people with cardiac arrhythmia

Seyed Abbas Haghayegh

Abstract
Aim. The aim of this study was to compare the effectiveness of acceptance-based therapy and emotion-based cognitive therapy on psychological well-being of patients with cardiac arrhythmia.
Background. The study of heart disease has long been noted by psychological factors because an individual with cardiac arrhythmias may suffer from mental well-being.
Method. This was a quasi-experimental study and to collect the data, a pre-test-post-test design with two experimental and one control group was used. The statistical population of the study consisted of all cardiac arrhythmia patients of Amirabad Heart Hospital in Tehran, out of which 60 people were selected by convenience sampling method and randomly divided into two experimental groups (20 people in each group) and one control group (20). The tools used in the present study included mental well-being (Reef, 1995), which were used in two stages of pre-test and post-test.
Findings. According to the findings, the mean score of psychological well-being in both experimental groups (acceptance-based therapy and emotion-based cognitive therapy) increased in the post-test stage compared to the pre-test, and these interventions increased the score of psychological well-being components in patients with heart arrhythmia compared to control group.
Conclusion. Clinicians can use these interventions (acceptance-based therapy and emotion-based cognitive therapy) in patients with cardiac arrhythmias to promote psychological well-being and recovery.

Effect of post– discharge telephone follow-up on medication adherence in patients with coronary angioplasty

Shiva Khaleghparast

Abstract
Aim. This study aimed to examine the effect of education about anti-platelet drugs consumption through telephone follow-up on medication adherence in patients with coronary angioplasty.
Background. Regarding the necessity of proper use of antiplatelet drugs after coronary angioplasty, adherence to treatment is of great importance, and it is considered as one of the major concerns.
Method. This quasi-experimental study was conducted on 392 patients with percutaneous coronary intervention. The patients were divided into two experimental (telephone fallow-up) and control (without telephone fallow-up) group for one year. Adherence to treatment was assessed using the Morisky Medication Adherence Scale before and after percutaneous coronary intervention. Data were analyzed using t-test, chi-square and linear regression model in SPSS software.
Findings. The mean age of patients was 61.71±10.28 years in the experimental group and 60.72±11.14 years in the control group. Changes in the mean score of medication adherence was 53.09±1.37 in the experimental group and 18.09±1.30 in the control group, indicating a statistically significant increase in medication adherence in the experimental group compared with the control group (P=0.001). Non-use of anticoagulants in the experimental group increased until the end of the sixth month of telephone follow-up and then, decreased until the end of the twelfth month of follow-up.
Conclusion. Since changes in the mean score of adherence to medication in the experimental and control groups was significant, it is recommended that follow-up interventions in patients be continued continuously for at least one year.

The effect of empowerment program on life satisfaction of people with coronary artery disease

Masoumeh Zakerimoghadam

Abstract
Aim. The present study was conducted to examine the effect of an empowerment program on the life satisfaction of patients with coronary artery disease.
Background. Because of the chronic and progressive nature of coronary artery disease, patients suffer frequent problems and relapses. Heart disease is considered as one of the debilitating diseases, and as such adversely affects the patient's self-care, quality of life, and health status.
Method. In this randomized clinical trial, 84 people with coronary artery disease, admitted to post-CCU wards in Tehran's Center for Heart diseases, were recruited in 2017. The study subjects were selected based on inclusion criteria. After explaining the study objectives and obtaining written signed consents, patients were assigned to experimental and control groups by blocking random allocation. Both groups completed questionnaires for demographic data and disease history, and Life Engagement Test. The Magic Empowerment Program was performed for experimental group as three workshop sessions for three consecutive days. Intervention continued after patients' discharge from the hospital through phone calls once a week for eight weeks. The Life Engagement Test was completed by the researcher for both groups, data were analyzed in SPSS-16 using descriptive and inferential statistics.
Findings. The results showed no statistically significant difference between groups in terms of demographic variables and disease history. Before intervention, there was no statistically significant difference between the mean scores of life satisfaction of experimental and control group and the two groups were homogeneous. After intervention, a statistically significant difference was observed between the groups in mean score of Life Engagement (P≤0.0001). The mean score of life satisfaction in experimental group, before and after the intervention was statistically significant (P≤0.0001), while in the control group there was no statistically significant difference.
Conclusion. The empowerment program increased life satisfaction of patients with coronary artery disease. Nurses can benefit from the empowerment program to improve life satisfaction, which is one of the dimensions of psychosocial health, in these patients.

The effect of couple therapy with well-being therapy method on depression, marital life quality, optimism and social well-being in patients with cardiovascular disease

AliAkbar Samari

Abstract
Aim. This study was conducted to examine the effect of couple therapy with well-being therapy method on depression, marital life quality, optimism and social well-being in patients with cardiovascular disease.
Background. Patients with cardiovascular disease experience many problems in their marital life and health, and one of the effective methods for improving the characteristics of marital life and their health is possibly the couple therapy with well-being therapy method.
Method. This study was a semi-experimental pretest- posttest study with control group. The study population was patients with cardiovascular disease referred to Javad Al-Aeme Cardiovascular Hospital in Mashhad city, Iran, in 2021. Thirty patients and their couples were recruited by purposive sampling method based on inclusion criteria and allocated to experimental (n=15 couples) and control (n=15 couples) group by simple random sampling. The experimental group received 8 sessions of 90-minute duration (two sessions per week) couple therapy with well-being therapy method and during this period the control group did not receive any intervention. Data were collected through the self-reported questionnaires of depression, marital life quality, optimism and social well-being and analyzed by Chi-square, independent t-test and multivariate analysis of covariance in SPSS-19 software.
Findings. The findings showed that the experimental and control groups were not significantly different in terms of education, gender, age and duration of cardiovascular disease. Before intervention, there was no statistically significant difference between groups in terms of the mean scores of depression, marital life quality, optimism and social well-being, but after intervention, a statistically significant difference was groups between experimental and control group in the mean scores of all four variables (P≤0.0001). The couple therapy with well-being therapy method led to reduced depression (F=192.046, P≤0.0001) and increased marital life quality (F=329.770, P≤0.0001), optimism (F=230.267, P≤0.0001) and social well-being (F=359.558, P≤0.0001) in patients with cardiovascular disease.
Conclusion. The results of this study indicated the effect of couple therapy with well-being therapy method on reducing depression and increasing marital life quality, optimism and social well-being in patients with cardiovascular disease. Health professionals and therapists can use this method to improve the characteristics of marital life and those related to health.

The effect of two high intensity interval training (HIIT) protocol on plasma levels of adiponectin, leptin and hypertension in overweight nurses

Amin Amini

Abstract
Aim. The aim of this study was to compare the effect of two high intensity interval training (HIIT) protocol on plasma levels of adiponectin, leptin and hypertension in overweight nurses.
Background. Cardiovascular disease, as a chronic and debilitating physical condition, is one of the most common causes of death worldwide and can affect the health of individuals, especially nurses who are exposed to a variety of diseases and it is necessary to identify variables related to health in these group.
Method. This was a clinical trial in which 27 nurses (mean age 25.81±0.6 years, mean height 158.01±7.6 cm and mean weight 69.41±0.25 kg) were selected and randomly divided into three groups of high intensity interval training type 1 (8 seconds of fast running and 12 seconds of active recycling), high intensity interval training type 2 (40-meter sweep test with maximum speed), and control group. High intensity interval training type 1 was performed for four weeks, three sessions per week, each session lasted 6-9 minutes with more than 90% of maximum heart rate. High intensity interval training type 2 was performed for four weeks, three sessions per week, with more than 90% of the maximum heart rate. The control group did not participate in any training program.
Findings. The study showed that HIIT type 1 and type 2 had a statistically significant effect on reducing plasma leptin levels, systolic and diastolic blood pressure and increasing plasma adiponectin concentration in nurses. Both training methods improved health indicators (adiponectin, leptin and systolic and diastolic blood pressure), but HIIT type 1 training caused more control and regulation of these indicators compared with compared to HIIT type 2.
Conclusion. There is a significant difference between type 1 HIIT exercise, type 2 HIIT exercise and control in research variables (adiponectin, leptin and blood pressure) in nurses.

Concept analysis of adherence to treatment in heart failure patients

Hosein Mahmoudi

Abstract
Aim. The purpose of this study was to explore and clarify the concept of adherence to treatment in people with heart failure.
Background. The concept of adherence to treatment, which determines the consequences of heart failure, is widely used in the literature. But this concept is very complex and needs a clear definition.
Method. In this study, the evolutionary approach of Rogers concept analysis was used. The main criteria for entry were texts published in English between 2004 and 2019. The data sources were the PubMed, Scopus, and EMBASE. A total of 73 articles were found out of which 37 articles were selected after omitting duplications, and after screening the studies based on Prism Diagram, 35 articles were studied.
Findings. After reviewing the studies, 5 words, adherence to medication, medication adherence, non-medication adherence or self-care recommendations, adherence to therapeutic guidelines, and non- adherence treatment were recognized as alternative terms, and two concepts, compliance and self-care were identified as the most important and the most common concepts related to adherence to treatment. Seven concepts were found as the features of the adherence to treatment (adaptability, being multidimensional and complex, participatory, dependent on demographic variables and underlying diseases, being conscious and dependent on education, measurable and predictive, and continuous and follow-up). Outcomes of the concept of adherence to treatment were directly related to the consequences of the concept.
Conclusion. Adherence to treatment is a complex, multidimensional, participatory, conscious, and measurable concept that depends on demographic variables that must be constantly monitored by the health care team. Adherence to treatment is evolving over time, both semantically and conceptually.

The relationship between spiritual intelligence and self-efficacy in patients with acute coronary syndrome admitted to cardiac care unit

Sima Zohari Anboohi

Abstract
Aim. This study aimed to address whether spiritual intelligence was correlated with self-efficacy in patients with acute coronary syndrome (ACS).
Background. Patients experiencing acute coronary syndrome (ACS) are often required to enhance their empowerment skills to manage their signs and symptoms in an effective manner. In this sense, self-efficacy has been considered as a useful factor to develop self-care practices and minimize the risks of coronary artery disease (CAD).
Method. Using a descriptive-correlational research design, a total number of 136 patients admitted to cardiac care units (CCUs) of the hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran, were selected through the convenience sampling. The data were further collected via the demographic characteristics information questionnaire, King’s Spiritual Intelligence Self-Report Inventory (SISRI, 2008), and the Cardiac Self-Efficacy Questionnaire (CSEQ) developed by Sullivan et al. (1998), and then analyzed using the SPSS version 22.
Findings. Most patients in this study (61.8 percent) were male, married (69.1 percent) with a mean age of 58.85. Moreover, the score of spiritual intelligence was 47.18. The patients received a mean score of 13.72 in the “critical existential thinking” subscale and a mean score of 10.19 in the “personal meaning production” subscale. The mean scores for the “transcendental awareness” and “conscious state expansion” subscales were also 9.70 and 9.47, respectively (p=0.01).
Conclusion. It was concluded that higher levels of spiritual intelligence could improve self-efficacy in patients affected with ACS; therefore, adopting strategies to boost this type of intelligence could augment resilience in such individuals.

Comparison of the effect of mindfulness-based cognitive therapy and acceptance and commitment therapy on sleep quality and health-promoting lifestyle behaviors in patients with heart failure

Tahereh Ranjbaripour

Abstract
Aim. The aim of this study was to compare the effect of mindfulness-based cognitive therapy and acceptance and commitment therapy on sleep quality and health promoting lifestyle behaviors in patients with heart failure.
Background. Consequences of heart failure create problems with sleep quality and lifestyle that affect the course of the disease. Mindfulness-based cognitive therapy and acceptance and commitment therapy are some of the potential effective interventions on those.
Method. The present study was a quasi-experimental with a pretest-posttest design and a control group with quarterly follow-up. The sample size was 45 people which were purposefully selected and then randomly assigned to two experimental groups (n=30) and one control group (n=15). Data were collected in three stages using the Sleep Quality Index Pittsburgh of Boyce et al. (1989) and the Health-Promoting Lifestyle Questionnaire of Walker et al. (1987). Mindfulness-based cognitive therapy and acceptance and commitment therapy for experimental groups were performed and data analysis was performed in SPSS-25 software through analysis of covariance.
Findings. Both acceptance and commitment therapy and mindfulness-based cognitive therapy in post-test and follow-up (F=181.224, P≤0.0001) and (F=62.315, P≤0.0001), improved sleep quality and health-promoting lifestyle behaviors when compared to the control group. Despite the effect of both interventions, the superiority of acceptance and commitment therapy (P< 0.001) on health promoting lifestyle was found. There was no statistically significant difference between two interventions (P=0.967) in terms of improving sleep quality.
Conclusion. According to the results, both interventions were effective on sleep quality and health-promoting lifestyle behaviors, especially acceptance and commitment therapy was more effective on health-promoting lifestyle behaviors, so, in medical settings it can be used along with medical treatments for patients with heart failure.

The effect of CardioPulmonary Cerebral Resuscitation (CPCR) on nurses’ knowledge and performance: Literature Review

Amir Tabatabaee

Abstract
Aim. The purpose of this study is to review studies that have investigated the effect of CardioPulmonary Cerebral Resuscitation (CPCR) training on nurses' knowledge and performance.
Background. CPCR is a systematic procedure and a set of targeted measures have been used by nurses to restore the vital functions of the body's central organs, such as the heart, lungs, and brain. The application of teaching is a suggested method for improving the knowledge and skills of nurses PCPR in most published articles.
Method. In this r eview study, a comprehensive search of scientific databases and sear ch engines such as Science Direct, PubMed, Cochrane, Medline, SID, Scopus, CINAHL, OVID, Iran Doc and Magiran using the keywords cardiopulmonary resuscitation, nurses, practice, knowledge in both Persian and English languages was done to find articles published between 2010 and 2022.
Results: CPCR training in both face-to-face and virtual form can be effective on the knowledge and performance of nurses, and in all studies there was a significant relationship between the scores before and after the training. The implementation of these trainings should be repeated for nurses permanently and every six months.
Conclusion: Basic training can lead to increasing the knowledge of nurses in the field of basic and advanced cardiopulmonary resuscitation. Based on this, regular theoretical and practical workshops and training courses are recommended.

What nurses need to know about interactions of diet containing vitamin K with warfarin: A review study

Elham Navab

Abstract
Aim. The present review study was conducted with the aim of exploring what nurses should know about interactions of diet containing vitamin K with warfarin.
Background. Warfarin is one of the most widely used oral anticoagulants. Dietary interactions, mainly due to vitamin K, are a common concern when consuming warfarin. In the meantime, the nurse, as the first person in the care chain and the main person in charge of patient education, can play an important role in reducing these interactions, which is a challenge for patients.
Method. The present review study was conducted through searching out library as well as databases such as PubMed, Cochrane Library, Web of Science, Scopus, Up-to-date, OVID, CINAHL, Magiran and SID using Persian keywords of warfarin, dietary interactions, vitamin k diet, patient and nurse education and their English equivalents in the period 1999 to 2021. Out of a total of 30 articles found, 8 articles were reviewed after screening the articles.
Finding. The findings of this study showed that the amount of vitamin K intake in the diet should be kept constant. This is 90 to 120 micrograms per day. Patients should be properly and continuously educated about vitamin K in various foods and supplements. In the meantime, the role of the nurse as one of the pillars of patient education is very important and fundamental.
Conclusion. Due to the role of the nurse in educating these patients, it is recommended that education about dietary interactions be used using authoritative sources. It is possible with methods such as preparing a clinical guide, making a video and designing an application, and including tables of vitamin K levels in foods.

Comparison the effect of education by Teach Back method and group education on self-efficacy of patients with myocardial infarction

Maryam Rezaei

ABSTRACT
Aim. The aim of this study was to investigate the effect of education by Teach Back method and group education on self-efficacy of patients with myocardial infarction.
Background. Cardiovascular diseases are among the leading causes of death worldwide. Effective education of patients requires the use of educational methods whose effectiveness have been identified.
Methods. The present study was a clinical trial conducted at Rajaie Cardiovascular Medical and Research Center in Tehran during 2020 and 2021. Sampling was performed continuously until 105 people were completed. Patients were randomly divided into three groups of 35, including group (Teach Back, group training, and Control), based on blocking randomization (size=6). The training sessions were conducted in two one hour sessions for two consecutive days. The control group received routine ward training. Data were collected using demographic information form and Sullivan Cardiac Self-Efficacy Questionnaire that completed before training by patients and two weeks after training by telephone by the researcher. Finally, data on 93 patients admitted to cardiac care unit were analyzed using SPSS software version 24.
Findings. Groups were homogenous in terms of demographic characteristics and disease history. The mean and standard deviation of self-efficacy score before training was 8.03±1.84 in teach back group, 7.58±2.16 in the group training and 6.90±1.40 in the control group. One-way analysis of variance showed that the mean score of self-efficacy before the intervention in the study groups was not statistically different, but two weeks after training, the mean and standard deviation of self-efficacy score was 51.6±7.85 in the teach back training, 45.77±8.39 in the group training group, and 23.16±9.13 in the control group. Increase in self-efficacy mean score in patients under teach back training was significantly higher than patients under group training and control group (P≤0.0001), and in patients under group training was significantly higher than patients in control group (P≤0.0001).
Conclusion. Teach Back training and group training increase the self-efficacy of patients with myocardial infarction. Due to the role of nurses in patient education, this educational methods can be used.

The effect of virtual reality therapy training on Covid-19 anxiety in patients with hypertension in Corona pandemic

Ali-Akbar Vaezi

Abstract
Aim. The present study was performed to examine the effect of virtual reality therapy training on Covid-19 anxiety in patients with hypertension in Corona pandemic.
Background. In addition to numerous physical problems, Covid-19 has had many psychological consequences such as stress and anxiety, especially in the community of chronic patients, including patients with hypertension. Therefore, appropriate interventions to reduce Covid-19 anxiety in patients with hypertension are essential.
Method. The present study was a quasi-experimental with a pretest-posttest design and a control group. The statistical population of the study consisted of all patients with hypertension referred to Ardakan Heart Clinic, Yazd, Iran. Using the available sampling method and according to the inclusion and exclusion criteria, 60 people were selected and randomly allocated to experimental (n=30) and control (n=30) group. Both groups completed the Alipour’s et al. (1398) Covid-19 questionnaire in the pre-test and post-test stages. The experimental group received the training in 6 sessions of one hour duration. Then, both groups completed the research questionnaires again in the post-test stage. Data were analyzed in SPSS version 26 using descriptive and inferential statistics.
Findings. After intervention, there was a statistically significant difference between the experimental and control group in terms of the mean scores of Covid-19 anxiety (P≤0.0001, F=110.807), psychological dimension of Covid-19 anxiety (P≤0.0001, F=78.30), and the physical dimension of Covid-19 anxiety (P≤0.0001, F=94.27).
Conclusion. Implementing virtual education intervention program with the content of reality therapy can reduce anxiety and its psychological and physical dimensions in people with hypertension.

Comparison of the effect of mentalization-based therapy and emotion-regulated therapy based on the Gross process model on psychological well-being and quality of work-life of nurses in intensive care units

Sheida Jabalameli

Abstract
Aim. This study was conducted to examine the effect of mentalization-based therapy and emotion-regulated therapy based on the Gross process model on psychological well-being and quality of work-life of nurses in intensive care units.
Background. Improving nurses' well-being and satisfaction with their quality of work-life improves the nurse-patient relationship and hospitals' performance from an organizational point of view. It is necessary to provide psychological therapeutic interventions to this crucial group of health care providers.
Method. This study was an experimental study (pre-test post-test with control group) in which 45 nurses working in intensive care units of selected Tehran hospitals, Iran, were selected by the convenience sampling method, and assigned to two intervention groups and one control group (15 nurses in each group). Reef's short-term psychological well-being and Walton's 32-item quality of work-life were used to measure dependent variables of the study. Then, mentalization-based therapy group received intervention in 8 sessions of 90 minutes as one session per week; and the treatment group based on emotion regulated therapy based on the Gross process model received the intervention in 8 sessions of 90 minutes, one session per week based on the protocol. No intervention was implemented for the control group. Data were analyzed using descriptive and inferential statistics in SPSS software.
Findings. Before the intervention, there were the highest scores for quality of work-life in the control group. At the end of the study and after the intervention, the scores of quality of work-life increased in all three groups, and no statistical significant difference was found between the groups. Before the intervention, the highest scores for psychological well-being was observed in the mentalization-based therapy group. (85.86±6.56), and after the intervention, although the psychological well-being scores of both interventions groups were higher than that of control group, but this diferrence was not statistically significant.
Conclusion. Based on the findings of this study, it seems that training sessions of mentalization-based therapy and emotion-regulated therapy based on the Gross process model improve the quality of work-life in nurses working in intensive care units, but the improvement was not statistically significant.

Comparison of the effect of integrative behavioral couple therapy, narrative couple therapy and couple schema therapy on affective capital and depression among people with coronary artery disease and their spouses

Mohsen Golparvar

Abstract
Aim. The aim of this study was to compare the effect of integrative behavioral couple therapy, narrative couple therapy, and couple schema therapy on affective capital and depression among people with coronary artery disease.
Background. Coronary artery disease is one of the heart diseases that can cause problems for couples.
Method. This was a semi-experimental study with a pretest and posttest design and control group. The statistical population consisted of people with coronary artery disease and their spouses out of which 64 couples were selected by purposive sampling method and randomly assigned to three experimental groups and a control group (16 couples in each group). Affective Capital Questionnaire and Depression Inventory of Beck was used to assess dependent variables in two stages. The three intervention groups were each treated for 8 sessions of 90 minutes and the control group did not receive any treatment. The data were analyzed in SPSS by descriptive and inferential statistics.
Findings. In terms of affective capital, there was a statistically significant difference of integrative behavioral couple therapy, narrative couple therapy and couple schema therapy with the control group (p ≤0.001), and of integrative behavioral couple therapy with narrative couple therapy and couple schema therapy (p ≤0.001). For depression, there was a statistically significant difference of the three intervention groups with the control group, and of integrated behavioral couple therapy and couple schema therapy with couple narrative therapy (p<0.05).
Conclusion. According to the results, integrative behavioral couple therapy, couple schema therapy and narrative couple therapy are effective in increasing affective capital and reducing depression in people with coronary artery disease and their spouses. It is recommended that these three interventions be used for these patients and their spouses in cardiovascular disease centers.

COVID-19 and cardiovascular complications

Masoumeh Zakerimoghadam

Abstract
Aim. The aim of this study was to review the cardiovascular disorders and complications caused by COVID-19.
Background. Coronavirus (COVID-19) disease is a viral disease caused by the SARS-CoV-2 virus. The virus was first discovered in Wuhan, China, and was declared a global pandemic due to its widespread prevalence. So far, about 500 million cases of and 6 million deaths from the disease have been reported worldwide. SARS-CoV-2 mainly causes respiratory problems, and fever, cough, shortness of breath, myalgia, fatigue and diarrhea are common symptoms of the disease. COVID-19 also causes cardiovascular disorders, which due to the importance of the impact of these disorders on the health of people in the community, in this article, studies and research conducted in this field were reviewed.
Method. The keywords “Covid-19”, “Coronavirus”, and “Cardiovascular complication” were searched out in databases, Web of Science, Scopus, PubMed, and Google Scholar. Out of 84 articles that were found the more relevant ones to the research topic were selected. After reviewing the studies thoroughly, 33 papers that were in line with the purpose of the study were selected and reviewed.
Findings. Studies and findings have shown that COVID-19 can cause cardiovascular complications such as cardiac arrhythmias, acute coronary syndrome, acute myocardial injury, myocarditis and heart failure.
Conclusion. Given the prevalence of COVID-19 and its high prevalence worldwide, it is important to be familiar with the cardiovascular disorders caused by the disease and how to treat and manage these disorders.

The effect of stress-based mindfulness therapy on psychological well-being and Covid-19 anxiety in people with cardiovascular disease

Khadijeh Moghadam

Abstract
Aim. The aim of this study was to evaluate the effect of stress-based mindfulness therapy on psychological well-being and Covid-19 anxiety in people with cardiovascular disease in Karaj, Iran.
Background. During the Covid-19 pandemic, people with cardiovascular disease have had many problems in the field of psychological health including anxiety. One of the effective modalities to manage anxiety is mindfulness therapy that potentially reduces stress and may affects psychological well-being.
Method. This was a quasi-experimental pretest-posttest study with a control group. The statistical population of the study included all women with cardiovascular disease in Karaj, Iran. Thirty people of the target population were selected by convenience sampling and randomly assigned to experimental and control group (15 people in each group). The research instruments included psychological well-being questionnaire (1989) and Corona anxiety questionnaire. Data were analyzed using descriptive and inferential statistics (multivariate and univariate analysis of covariance) in SPSS software version 19.
Findings The results showed the effect of stress-based mindfulness on psychological well-being and Corona anxiety in women with cardiovascular disease (p≤0.0001). The intervention explained 43% of the variance of psychological well-being and 24% of the Corona anxiety.
Conclusion. Considering the effectiveness of stress-based mindfulness therapy on psychological well-being and Corona anxiety in people with cardiovascular disease, it is suggested to apply this treatment method in psychological clinics and health centers to improve mental health.

Comparison the effect of positivism education and health promoting lifestyle education on psychological well-being and health anxiety in cardiovascular patients: An interventional study

Zahra DashtBozorgi

Abstract
Aim. This study was conducted to compare the effect of positivism education and health promoting lifestyle education on psychological well-being and health anxiety in people with cardiovascular disease.
Background. People with cardiovascular disease have problems in the terms of psychological well-being and health anxiety and positivism education and health promoting lifestyle education are likely to be effective in improving psychological well-being and health anxiety.
Method: The present study was a semi-experimental study with pre-test and post-test design with a control group. The study population consisted of people with cardiovascular disease who referred to Golestan Hospital of Ahvaz city, Iran, in 2021. Sixty people were recruited by purposive sampling method based on inclusion criteria and randomly assigned to three equal groups. Experimental groups separately underwent 8 sessions of 90-minute duration by positivism education and health promoting lifestyle education, respectively, and during this time the control group did not receive any intervention. Data were collected by the demographic information form, short form health anxiety inventory and psychological well-being revisited questionnaire, and were analyzed by Chi-square, univariate analysis of variance, multivariate analysis of covariance and Bonferroni post-hoc test in SPSS-19 software.
Findings. The findings showed that the experimental and control groups did not significantly differ in terms of gender, education level, age and duration of cardiovascular disease. Both methods of positivism education and health promoting lifestyle education were effective in improving psychological well-being and health anxiety in people with cardiovascular disease (P≤0.0001), but there was no statistically significant difference between the intervention methods in improving psychological well-being and health anxiety.
Conclusion. The effect of both methods of positivism education and health promoting lifestyle education on improving psychological well-being and health anxiety was confirmed and there was no significant difference between these methods in improving psychological well-being and health anxiety. Therefore, health professionals and therapists can use both methods to improve health-related characteristics.

Comparison of the prevalence of neck pain and disability among nurses working at intensive care units and general wards

Maryam Talebi

Abstract
Aim. This study was conducted to compare the prevalence of neck pain and disability among nurses in intensive care and general wards.
Background. Nursing is known as one of the ten occupations that are associated with musculoskeletal complications. In has been reported that neck and shoulder disorder are more common among nurses with high physical workload than those with low physical workload. So far, few studies have been performed on neck problems in nurses working at intensive care unit.
Method. In this cross-sectional descriptive-comparative study, 40 nurses from intensive care units and 40 nurses from general wards of Rasool Akram hospital, Tehran, Iran, were selected by convenience sampling method. Data collection in both groups was done through completing a checklist of demographic characteristics, Neck Disability Index (NDI) and Neck Pain and Disability Scale (NDPS) questionnaires by participants. The data was analyzed in SPSS version 22 using descriptive and inferential statistics.
Findings. The prevalence of neck pain and disability (measured by NDI and NPDS) in all nurses was 77.5 percent and 60 percent, respectively; 90 percent and 70 percent in nurses working at the intensive care units, and 65 percent and 50 percent in nurses working at general wards. The difference in scores measured by NDI was statistically significant between nurses working at the intensive care units and those working at general wards (P=0.014).
Conclusion. The prevalence of neck pain was significantly high in nurses, which could be due to their high workload that requires appropriate preventive measures and reduction of their physical workload.

Factors affecting the survival of patients with acute myocardial infarction hospitalized in the cardiac care unit of Shahid Sayad Shirazi Teaching and Medical Center of Golestan University of Medical Sciences, Iran, in a 5-year period (2013-2018)

Asemeh Izadpanah

Abstract
Aim. The present study was conducted to determine the factors affecting the survival of myocardial infarction (MI) patients hospitalized in the cardiac care unite (CCU) at the 5-year period (2013-2018).
Background. By knowing the factors affecting survival, it is possible to focus more on prevention and treatment protocols.
Method. This is a retrospective cohort study investigating the data from the records of 277 patients with acute myocardial infarction (MI) hospitalized in the CCU ward of Shahid Sayad Shirazi Teaching and Medical Hospital affiliated to Golestan University of Medical Sciences, Iran, over a 5-year period from 2013 to 2018. The convenience sampling method was used, and the inclusion criteria encompassed those with diagnosed MI based on the report of cardiologist, disease history, signs in electrocardiogram (ECG), and cardiac enzyme marker tests. The instrument used for data collection included a list of clinical information, laboratory parameters, and demographic information. The data were analyzed in SPSS-16, using descriptive and inferential statistics.
Findings. This study revealed that 187 patients (67. percent) were males, and the mean age of expired patients was significantly higher than the recovered ones (P=0.002). Moreover, the mean cholesterol and blood sugar values in the expired patients were significantly higher than the recovered ones (P=0.033, P=0.015, respectively). Correspondingly, there were a statistically significant differences in the mean value of hemoglobin and red blood cells between the two groups (P=0.002, P=0.047, respectively). MI patients who didn’t use drugs, cigarettes, and water pipe and had no systemic diseases were more likely to survive compared to those with a history of addiction and systemic diseases (P=0.04, P=0.029). Finally, the survival graph showed that 50 percent of the patients were alive until the 11^th day of hospitalization (median survival time, 11 days).
Conclusion. Determining the factors affecting the survival rate of patients after MI can be the focus of prevention and screening programs for high-risk groups of patients with acute myocardial infarction. Hence, increasing the survival of patients with acute MI requires health policymakers to take comprehensive actions at prevention levels.