Cardiovascular Nursing Journal

Resilience and influential factors in critical care nurses: A literature review

Ehsan Khalilipur

Abstract
Aim. This research aimed to identify and analyze the factors affecting resilience in nurses working in Intensive Care Units (ICUs) in Iran.
Background. Resilience is defined as the ability of individuals to resist, adapt, and recover from shocks and stresses while maintaining their functions. This concept is influenced by individual characteristics such as hope, optimism, and coping strategies, as well as social and environmental factors like social support, community cohesion, and effective governance, which play a key role in shaping resilience.
Methodology. In this review study, the keywords resilience, nurses, and intensive care unit, along with their English equivalents, were used. The Persian databases utilized included SID, MagIran, IranMedex, and the database of scientific journals of medical universities in the country. International databases included PubMed, Scopus, and Web of Science, and the Google Scholar search engine was also used. Ultimately, 20 articles were evaluated in the study.
Findings. Resilience in ICU nurses is a vital construction influenced by various factors. To improve nurses' resilience, interventions should be comprehensive, targeting both individual and organizational factors.
Conclusion. Regular assessment of nurses' resilience levels and monitoring the effectiveness of interventions through continuous qualitative and quantitative research are essential to ensure that strategies adapt to the changing needs of this critical group of healthcare personnel. This approach will not only improve the mental health of nurses but also directly lead to an enhancement in the quality of healthcare and the sustainability of the nursing workforce in the future.

Effect of distance education based on health belief model on health literacy in people with heart failure: A clinical trial

Zahra Alizadeh

Abstract
Aim. This study was conducted to examine the effect of distance education based on health belief model on health literacy in people with heart failure.
Background. Inadequate health literacy is strongly associated with adverse clinical outcomes in people with heart failure. Although education of or developing educational material for patient and family members during and in the time of discharge is considered a principle step, it is not enough and the follow up care must be planned.
Method. In this clinical trial, 80 participants were randomly assigned to either experimental or control group. Balanced block randomization with a block size of two was used for allocation. The intervention group received structured education via the “Etaa”, an Iranian messaging application, nurse follow-ups, and routine care, whereas the control group received routine care only. Data were collected using the Heart Failure Health Literacy questionnaire, before the intervention, one month after the intervention, and three months post-intervention.
Findings. The results indicated that the mean health literacy scores in the experimental group were significantly higher than those in the control group (P≤0.0001), with a strong Cohen's d effect size of 2.8.
Conclusion. These findings suggest that educational interventions based on the health belief model can effectively enhance health literacy and adherence to treatment in people with heart failure.

The relationship of satisfaction with nursing care and readiness for discharge in the elderly after heart surgery

Hamid Peyrovi

Abstract

Aim. This study aimed to examine the relationship between satisfaction with nursing care and readiness for discharge among elderly patients after cardiac surgery at Shahid Rajaee Cardiovascular Medical and Research Center, Tehran, Iran.

Background. Satisfaction with nursing care and readiness for hospital discharge are essential indicators of healthcare quality. With the growing elderly population and increasing prevalence of cardiovascular diseases, assessing these variables in cardiac surgery patients is of great importance.
Method. In this descriptive-correlational cross-sectional study, 300 elderly patients undergoing cardiac surgery were enrolled using convenience sampling. Data were collected using a demographic questionnaire, the Newcastle Satisfaction with Nursing Scale (NSNS), and the Readiness for Hospital Discharge Scale (RHDS). Data were analyzed using SPSS version 26 with descriptive statistics, Pearson correlation, and multiple regression analysis.
Findings. The mean satisfaction score was 53.22±8.4, and the mean discharge readiness score was 6.1±1.7. There was a statistically significant positive correlation between satisfaction with nursing care and discharge readiness (r=0.46, p≤0.0001). Gender and education level were associated with satisfaction, while income level was associated with discharge readiness.
Conclusion. The findings indicated that patient satisfaction with nursing care is positively related to discharge readiness. Enhancing discharge education, nurse–patient communication, and nursing care quality can improve readiness for discharge among elderly cardiac surgery patients.

Incidence of complications in patients after open heart surgery at Jamaran Heart Hospital in Tehran, Iran, 2022-2023

Tayeb Moradian

Abstract

Aim. The present study was conducted with the aim of investigating the incidence of complications after cardiac surgery in the period from the patient's admission to the ward to three days thereafter at Jamaran Heart Hospital in 2022-2023.

Background. Regarding the selected and proposed treatments for cardiovascular diseases, every year a large number of patients undergo heart and coronary artery bypass graft surgery and valve repair or replacement. According to the surgical procedure, there are many cardiac and non-cardiac complications for these patients.

Method. The present study was a cross-sectional descriptive study that was conducted between 2022 and 2023 in Jamaran Heart Hospital in Tehran, Iran. In this study, 254 patients who were candidates for heart surgery were recruited using convenience sampling method. Data were collected using demographic characteristics form, checklist for short-term complications after open heart surgery, and numerical pain scale. The time period of data collection was from the moment the patient entered the intensive care unit to the time of transfer to the ward (three days). The data were analyzed in SPSS version 22 using descriptive statistics.

Findings. Most of patients underwent valve surgery or combined valve and coronary artery graft surgery (68.1 percent). Most of patients were male (62.3 percent), and had a history of high blood pressure (60.5 percent). The mean of age and ejection fraction at discharge was 60.4 years and 48.4 percent, respectively. On the third day after surgery, the incidence of complications was as follows: atelectasis, 18.9 percent; pleural effusion, 15 percent; and pneumothorax, 2.8 percent. The highest average pain score was 3.74 when using incentive spirometry and 4.54 when coughing. Regarding arrhythmia, the highest rate was related to sinus tachycardia (12.6 percent) and atrial fibrillation (9.6 percent).

Conclusion. Goal-directed planning is necessary to manage complications after open heart surgery. Conducting more studies with the aim of investigating etiology and appropriate management of risk factors is also suggested.

Factors affecting the prevention of cardiovascular diseases in older adults: A systematic Review

Abstract
Aim. This review aimed to identify and analyze lifestyle factors influencing the prevention of cardiovascular diseases (CVD) in older adults, and to evaluate the combined effects of diet, physical activity, smoking avoidance, and body mass index (BMI) control.
Background. Cardiovascular diseases are a leading cause of morbidity and mortality in older adults. Lifestyle modifications, including dietary habits, exercise, and smoking cessation, are effective and low-cost preventive interventions. Understanding the impact of these factors individually and synergistically can guide public health and clinical strategies.
Methodology. A systematic review was conducted based on PRISMA 2020 guidelines. Studies published between 2015 and 2025 on CVD prevention in adults aged ≥60 were searched out from Persian and international databases (SID, MagIran, IranMedex, PubMed, Scopus, Web of Science). Eligible studies included original research (cross-sectional, cohort, and clinical trials) in Persian or English. Data extraction and quality assessment were performed systematically, and 22 studies met the inclusion criteria for final analysis.
Findings. Evidence indicates that a healthy diet, including Mediterranean or plant-based patterns, regular physical activity ≥150 minutes per week, smoking avoidance, and BMI control, collectively reduce cardiovascular risk factors and the incidence of CVD. Adherence to healthy dietary patterns decreased BMI, LDL-C, triglycerides, and HbA1c. Regular exercise demonstrated synergistic benefits with diet and smoking cessation, lowering the risk of myocardial infarction, stroke, and other cardiovascular events. Lifestyle interventions in pre-diabetic or metabolically at-risk populations slowed the progression of metabolic disorders and reduced the incidence of type 2 diabetes.
Conclusion. Promoting and adhering to a healthy lifestyle in older adults is an effective strategy for both primary and secondary prevention of cardiovascular diseases. Comprehensive, multidimensional lifestyle programs not only improve individual health but also reduce the societal and economic burden of CVD and enhance quality of life in the aging population.

The moderating role of health beliefs in the relationship between psychological well-being and adjustment to illness in patients with cardiovascular disease

, Bayane , Abdollah Zadeh

Abstract
Aim. The aim of the present study was to predict adjustment to the disease in patients with cardiovascular disease based on psychological well-being with the moderating role of health beliefs.
Introduction. Health beliefs are directly related to an individual's adaptation and behavior, and the outcome of this adaptation affects the patient's perception of disability and quality of life. Effective assessment and understanding of illness involves understanding the individual's ability to demonstrate adaptive behaviors and estimating their success in regulating symptoms of the disease, and subsequently, seeking psychological well-being.
Method. This was a descriptive correlational study. Three hundred patients with cardiovascular disease referring to Martyr Dr. Qolipour Medical Center in Bukan, Iran were recruited by purposive sampling. To collect the data, Health Beliefs Questionnaire, Psychosocial Adjustment to Illness Scale, and Psychological Well-being scale were used. Inclusion criteria included cardiovascular disease, having at least a high school education, no acute physical illness other than cardiovascular disease, no acute mental illness, and willingness to participate in the study.
Findings. According to the results, in patients with cardiovascular disease, adjustment to the disease had a statistically significant positive relationship with psychological well-being and health beliefs (P≤0.01). Psychological well-being and health beliefs had the ability to predict adaptation to the disease, and health beliefs had a moderating role in the relationship between psychological well-being and adjustment to the disease.
Conclusion. In general, it can be concluded that in patients with cardiovascular disease, psychological well-being and health beliefs predict adjustment to the disease, and health beliefs can moderate the relationship between psychological well-being and adjustment to the disease.

The effect of methamphetamine exposure on maternal hypertension during pregnancy and maternal-infant outcomes in young women with substance use disorder

Elahe Ghaderi

Abstract
Aim. This study evaluated the effects of prenatal substance abuse, predominantly Methamphetamine (MA) , on obstetric complications and neonatal health in an Iranian tertiary referral center.
Background. Methamphetamine abuse during pregnancy is a critical public health concern with significant implications for maternal and neonatal outcomes.
Method. A retrospective cohort study was conducted in 2021 at Shahid Akbar Abadi Hospital, Tehran. Three hundred and twenty two pregnant women were divided into a substance-using case group (n=98) and a non-using control group (n=224). Maternal and neonatal data were extracted from medical records and analyzed using statistical methods.
Findings. The case group was significantly older with lower education; MA was the predominant substance (75.5 percent). Major obstetric complications were significantly higher in the case group, including premature rupture of membranes (32.3 percent), gestational hypertension (20.4 percent), and preeclampsia (9.2 percent). Neonates in the case group experienced significantly higher rates of respiratory distress syndrome (49.0 percent), intrauterine growth restriction, and NICU admission (71.4 percent). Notably, head circumference was significantly reduced in the case group (P<0.001) despite comparable birth weights to controls, suggesting selective neurotoxic effects on brain development rather than global growth restriction.
Conclusion. Prenatal MA exposure is a significant predictor of hypertensive disorders and neonatal neurodevelopmental risk characterized by selective brain growth restriction. Given the substantial neonatal morbidity, comprehensive multidisciplinary care and universal screening for substance use are essential for optimizing outcomes in this vulnerable population.

The relationship of informational support and anxiety among family members of patients admitted to the intensive care unit

Morteza Mohammadzadeh

Abstract
Aim. The aim of this study was to examine the relationship of informational support and anxiety among family members of patients admitted to intensive care units (ICUs) in selected educational and medical centers in Hamadan city, Iran, in 2024.
Background. Families of ICU patients frequently experience high levels of anxiety, which may lead to physical and psychological complications. Research indicates that one of the most significant factors contributing to anxiety among family members is a lack of information and familiarity with the ICU environment.
Method. This was a descriptive-correlational study. A total of 191 family members of ICU patients in selected educational and medical centers in Hamadan were recruited using a convenience sampling method, based on predefined inclusion criteria. Data collection tools included a demographic information questionnaire, the Spielberger State-Trait Anxiety Inventory, and Informational Support questionnaire. Data were analyzed using SPSS version 16, applying both descriptive and inferential statistics.
Findings. The findings indicated that the mean anxiety score of participants was 45.7±6.62, with the majority falling within the moderate anxiety range. The mean score of informational support was 46.18±9.78. Pearson correlation test showed a statistically significant positive relationship between the level of informational support and anxiety (r=0.29, P=0.006). One-way ANOVA revealed a statistically significant association between education level and anxiety among family members (F=4.222, P=0.006). Furthermore, informational support was significantly associated with education level and employment status. No statistically significant associations were found between other demographic variables and either anxiety or informational support.
Conclusion. Anxiety among family members of ICU patients is common and typically of moderate severity. Contributing factors include the stressful environment, lack of awareness about the patient's condition, and educational background. Contrary to expectations, increased informational support from healthcare staff did not reduce anxiety and in some cases appeared to increase it, potentially due to the manner of information delivery and the psychological state of family members. These findings highlight the importance of considering demographic characteristics when designing psychological and informational interventions. Recommended strategies include open visitation, education, family involvement, and the presence of a psychologist.