Cardiovascular Nursing Journal

Mental health status of critical care nurses in teaching hospitals of Tehran

Faezeh Bogheiri

Abstract

Aim. This study was conducted with the aim of evaluating mental health status in critical care nurses working in Coronary Care Unit (CCU), Intensive Care Unit (ICU), Emergency Department (ED) and dialysis ward in teaching hospitals of Tehran, Iran.

Background: Nursing is known as a difficult profession which needs an endless patience and tolerance with patients and their families. Furthermore, nurses must update theirs knowledge in all nursing-related topics, but it seems that it is so hard for nurses to update knowledge and at the same time, do their professional tasks such as meeting patients and family needs which occupy nearly all their time. This could run them at risk mentally and physically. Besides, it is much more possible for critical care nurses to be affected because of aggravated work-related stresses.

Method: This is a cross- sectional descriptive study. The sample included 375 critical care nurses with at least one year of nursing experience and six months of working in critical care wards. The convenience sampling method was used. Three valid and reliable questionnaires were used in this

study: "Chalder Fatigue Questionnaire", "Hamilton Anxiety Rating Scale", and "Pittsburgh Sleep Quality Index". Questionnaires were filled by study participants and the data were analyzed by SPSS.

Findings: The findings revealed that %73 of nurses experienced mild levels of anxiety, and %16.5 of them reported mild to moderate levels of anxiety. The remaining had either moderate to severe or severe levels of anxiety. Regarding sleep quality, %89.2 of the samples had bad sleep quality. In terms of fatigue, all participants reported moderate to severe fatig.

Conclusion: Critical care nurses in teaching hospitals of Tehran do not have satisfying mental health status. Most of them are suffering from bad sleep quality, moderate to severe fatigue, and mild or mild to moderate anxiety.

Complications of intravenous Streptokinase therapy in acute myocardial infarction patients admitted to the cardiac intensive care unit

Neda Sayadi

Abstract

Aim. The aim of this study was to evaluate complications of intravenous Streptokinase therapy in acute myocardial infarction patients admitted to the cardiac intensive care unit.

Background. Myocardial infarction is a common disease and the use of thrombolytic agents such as Streptokinase reduces its mortality, but there are some complications associated with streptokinase.

Method. In this descriptive stud y 120, patients treated with streptokinase were evaluated in terms of complications of the drug. A checklist of Streptokinase complications was used to collect the data. The findings were presented in the form of descriptive and inferential statistics.

Findings. According to the finding s, %33.3 of patients had cardiovascular complications, %23.9 developed allergic symptoms, and %17.5 suffered blood complications.

Conclusion. The incidence of cardiac complications was the highest among patients. It is recommended to train nurses to avoid possible complications.

Comparative study of the effect of muscle relaxation and music therapy on anxiety level in patients waiting for cardiac catheterization

Masoomeh Zakerimoghadam

Abstract

Aim. The aim of this study was to examine the effect of muscle relaxation and music therapy on anxiety level in patients waiting for cardiac catheterization.

Background. Anxiety is one of the most common human emotions from positive or negative experiences of life. High levels of anxiety have many unwanted effects on the body systems. In stressful situations such as invasive diagnostic techniques, the person experiences high level of anxiety. One of the main responsibilities of nurses is to control anxiety in patients with pharmacological and non-pharmacological methods.

Method. This quasi-experimental study was conducted in one hospital affiliated to Tehran University of Medical Science. After obtaining approval and written consent, 150 patients, waiting for cardiac catheterization, were randomly divided into three groups of muscle relaxation, music therapy and control. Data were collected by demographic form and self-report form of anxiety through interview. One hour before cardiac catheterization, the level of anxiety was measured in all groups, then, muscle relaxation group was asked to perform Benson muscle relaxation for 20 minutes based on listening to a recorded tape of guidance by headphone. At the same time, the music therapy group listened to music tape by headphone. Control group received no intervention but standard nursing care. Immediately before cardiac catheterization, the level of anxiety was measured again in all groups. Data were analyzed by SPSS using Fisher exact test, Mann-Whitney and Kruskal-Wallis tests.

Findings. Immediately before catheterization, patients' anxiety level was significantly reduced (p<0.001) in muscle relaxation and music therapy groups, while it increased in the control group. Immediately before catheterization, a statistical significant difference was found between levels of anxiety in groups (p<0.001).

Conclusion. Both Benson muscle relaxation and music therapy significantly reduced anxiety level of patients and music therapy had more effect on the anxiety level of patients waiting for cardiac catheterization.

The effect of simulation training method on enabling student nurses in advanced pre-hospital operation

Malahat Nikravan-Mofrad

Abstract

Aim. This study examined the effect of using simulation training method on enabling student nurses in advanced pre-hospital care.

Background. Disaster nursing includes especial operational skills to manage disasters victims. These skills mainly include advanced pre-hospital care. To teach these skills, simulation in workshop environment is one of the most valuable and effective methods, one type of which is the use of live models in scenarios of various events that can be implemented and practiced in simulated

environment.

Method. This study was conducted by a quasi-experimental design in which 7 30th semester student nurses were recruited by census sampling and undergone training by simulation method. In this study, three tools (questionnaire, clinical evaluation form, and self-assessment form) were used. The data were managed and analyzed by SPSS, version 16. Findings. At the end of workshop in a simulated environment, %100 of students scored at good level. Also, in terms of pre-hospital skills, %100 of students scored at proficient level. In addition, after the workshop, %100 of students evaluated themselves at completely dominant level.

Conclusion. The results of this study indicate that training by simulation method can teach student nurses the knowledge and necessary skills for pre-hospital emergency care in the best way. Besides, it can improve students' self-assessment on their capabilities.

Effect of self-care education on quality of life among patients with permanent pacemaker

Esmat Ataee

Abstract

Aim. The aim of this study was to examine the effect of self-care education on quality of life in patients following pacemaker implantation.

Background. One of the most common causes of death after myocardial infarction is arrhythmia resistant to treatment. This type of arrhythmia can be managed by pacemaker. The quality of life after pacemaker implantation is usually low, and self-care education may be a method to address this issue.

Method. In a randomized clinical trial study, 80 patients, candidate for permanent pacemaker implantation at Rajaie Cardiovascular, Medical and Research Center, were recruited to either control or experimental group through the blocked randomization. Data were collected using demographic form and the MacNew health-related quality of life questionnaire. The experimental group patients, in accompany with one first-degree relative, received one session of self-care education on the preimplantation day. The content of this 30 minutes session was "how to use educational footage and pamphlets, and also, a face-to-face education. At the end of the session, the patients were given an "educational package". Following implantation, the experimental group patients were contacted once a week for one-month period. The data were analyzed by SPSS, version 15, using inferential statistics.

Results. There were no statistically significant difference between the experimental and control groups in the mean scores of emotional, physical, and social aspects of quality of life and overall quality of life, before self-care education however, after intervention, a statistically significant difference was found in all these variables between experimental and control groups (P=0.004).

Conclusion. Self-care education could have an effect on the quality of life of patients after permanent pacemaker implantation.

The effect of an eight-week aerobic training on high sensitivity C-reactive protein of high school students with different body mass indexes

Arezoo Tabrizi

Abstract

Aim. The purpose of this study was to determine the effect of -8week aerobic training on serum levels of high sensitivity C-reactive protein (hs-CRP) in high school male students with different Body Mass Indexes (BMI).

Background. The low-grade chronic inflammation, which is characterized by increased levels of inflammatory markers in blood (such as CRP, Interleukin 6) is a strong risk factor for some chronic diseases. The hs-CRP is the most sensitive marker of inflammation and independent predicator of cardiovascular diseases and increase in hs-CRP levels are associated with obesity and cardiovascular diseases. The effect of aerobic training on hs-CRP of adolescents with different BMIs needs further investigation.

Method. In this quasi-experimental study, 24 healthy and non-athlete boys (mean age, 16.33 and standard deviation, 0.47 years) were divided into three groups "thin, normal, and overweight or obese" according to their BMI. The training program included -8week (three sessions per week) progressive aerobic running at intensities of %75-60 of maximal heart rate. To determine changes in hs-CRP levels, the blood samples were collected before and after training program in the identical conditions.

Findings. Training program had no significant effect on hs-CRP levels in all groups. There was a statistically significant difference in hs-CRP levels between obese group and the other two groups in esponse to training program, both before and after intervention.

Conclusion. Eight-week aerobic training did not have a significant effect on hs-CRP of the subjects, likely due to insufficient intensity and duration of exercise training and low baseline hs-CRP levels. Decreased hs-CRP levels in obese group, compared with other groups, was likely due to the obesity status and higher baseline hs-CRP levels.

Treatment of heart failure by Cardiac Resynchronization Therapy (CRT) through Biventricular Pacing (BVP): A review article

Jamaleddin Begjani

Abstract

Aim. The aim of this review study is to introduce the cardiac resynchronization therapy through biventricular pacing in treatment of heart failure.

Background. More than 22 million peoples worldwide suffer from congestive heart failure (CHF). As a result of the lack of synchronized contraction, both within and between the ventricles, blood moves through the heart and body at a slower rate. Heart failure impacts on almost all aspects of the quality of life of patients, particularly on mobility. Despite treatment advances such as lifestyle changes, medication and heart surgery, up to %40 of patients with CHF suffer an arrhythmia that further reduces the heart’s ability to beat properly. Cardiac Resynchronization Therapy (CRT) is a new, adjunctive and effective therapy that can relieve CHF symptoms by improving the synchronization of the heart’s contractions.

Findings. According to the studies, after BVP, heart contractility, and left ventricular ejection fraction and stroke volume increase, the incidence of cardiac arrhythmias decreases and some aspects of quality of life such as exercise tolerance improves.

Conclusion. Cardiac resynchronization therapy (CRT) along with other medical options can be safely performed and can relieve CHF symptoms by improving the coordination of the heart’s contractions.

Problems in patients with coronary artery disease: A review article

Mohammad mojalli

Abstract

Aim. The aim of this review study was to describe psychosocial problems in patients with coronary artery disease and determine strategies to prevent and deal with.

Background. The prevalence of cardiovascular diseases is rising in industrial and developing countries. According to the report of World Health Organization, cardiovascular diseases are accounted for a large percentage of mortalities. The most common cardiovascular disease is coronary artery disease that produces problems for people and worries in community.

Method. A systematic search was conducted on studies published in the last 20 years by using databases such as OVID, PROQUEST, SCIENCE DIRECT, GOOGLE SCHOLAR, EBSCO, SID, MAGIRAN and IRAN MEDEX with keywords such as problems, patients, coronary artery disease and related keywords. Because the aim of this study was describing the psychosocial problems of patients after coronary artery disease, physical problems was excluded.

Findings. About 70 article in English and 20 articles in Persian were found about psychosocial problems after coronary artery disease. Patients' problems were categorized in three categories: educational needs of patients with coronary artery disease, consequences of psychosocial outcomes of coronary artery disease, and different consequences for men and women with coronary artery disease.

Conclusion. Because the heart is a sensitive organ, any heart disease can jeopardize patient identity, and psychosocial effects of heart disease is more prominent than physical effects. So, it is necessary to inform patients about the nature of disease and its causes, and how to implement secondary prevention and rehabilitation to return to work and normal life. Accordingly, continuous care for self-care is of great importance. This can be established by community-based clinics for secondary prevention. Especial attention to issues of women with coronary artery disease is essential.