Cardiovascular Nursing Journal

The effect of mindfulness-based cognitive therapy on depression in male patients with coronary artery disease

Kolsoum Kariminajad

Abstract

Aim. This study examines the effect of mindfulness-based cognitive therapy on depression in male patients with coronary artery disease.

Background. After heart events such as acute myocardial infarction, the patient experiences psychological distress. Approximately 65 percent of anxiety symptoms predict poor quality of life reduce return to work and increase risk of mortality.

Method.This is an experimental study with two groups and three stages. Forty male patients with coronary artery disease were randomly allocated to either control or trial group after they had been detected as having a "Beck depression inventory" score of one standard deviation higher than the mean score. The mean score of depression was also evaluated in both groups, immediately and two months after the intervention experimental group. The data were analyzed by SPSS Version 19 and covariance analysis.

Findings.The results showed a statistically significant difference between groups in terms of depression score, immediately and two months after intervention in experimental group (P<0.0001).

Conclusion.Based on the effect of mindfulness-based cognitive therapy on reducing depression in patients with coronary artery disease, it is suggested to implement this method for these patients.

Nurses viewpoint about visiting in coronary care unit

seyysed moslem mahdavi shahri

Abstract

Aim. The aim of this study was to evaluate nurses' views about visiting in coronary care unit (CCU).

Background. Social support includes emotional and instrumental support provided by family and friends who visit the patient. Visiting is shown to be influential on patients' recovery. On the other hand, visiting time has been an issue of the medical staff, patients and visitors.

Method.In this descriptive cross-sectional study, 140 nurses working in CCU participated in the study. Data were collected by the use of demographic questionnaire and "The Beliefs and Attitudes Toward Visitation in ICU Questionnaire" (BAVIQ). The data were analyzed by descriptive and inferential statistics using SPSS Version 19.

Findings. Most nurses believed that visiting interferes with direct nursing care (65%), and causes nurses to spend more time in providing information to the patients’ families (82.8%). Most nurses (85%) did not desire to liberalize the visiting policy of their unit.

Conclusion. The results of the study showed that CCU nurses have rather negative viewpoints toward visiting and open visiting policy that is in conflict with emotional needs of patients and their families.

Evaluation of nursing students’ performance related to cardiopulmonary resuscitation skills in critical care master course by objective structured clinical examination

Masoomeh Imanipour

Abstract

Aim.The purpose of this study was to evaluate nursing students’ skills in cardiopulmonary resuscitation (CPR) in their critical care master course.

Background.CPR is a common procedure in intensive care settings and the nurses have an important role in this regard. To consider the aim of training critical care nursing students, and increasing quality of care in intensive care settings, the evaluation of students’ skills in CPR is essential to determine defects and plan for improvement.

Method. In this descriptive study, nursing students’ performance was evaluated at the end of educational period of their critical care course using objective structured clinical examination (OSCE). The OSCE included five core skills in CPR: airway management, arterial blood gas (ABG) interpretation, basic life support, electrocardiography (ECG) interpretation and assessment of the level of consciousness.

Findings. The study population consisted of 17 nursing students in the 4^th semester of their critical care master course. The results showed the majority of students (64.7%) had moderate performance to do CPR skills. The best performance was related to assessment of the level of consciousness (52.9%). Basic life support (41.2%), airway management (35.3%) and ECG interpretation (11.8%) ranked as the next best skills, respectively. The worse performance was related to ABG interpretation with 0% pass score.

Conclusion. According to the findings, the performance of the nursing students in CPR is moderate, globally and cognitive skills are lower than psychomotor skills. Problem-based educational strategies and encouragement of active thinking are suggested for improving cognitive skills and more practice to improve all competencies up to desirable level.

Theeffect of family presence at the bedside on serum cortisol levels and physiological indexes in patients hospitalized in intensive care unit

mojdeh navidhamidi

Abstract

Aim.The aim of this study was to examine the effect of family presence at the bedside on serum cortisol levels and physiological indexes increasing in stressful situations.

Background.Family has a significant role inrecoveryof patients. Stress andanxiety are perceived reasons for limiting visitation in critical care units.

Method. This was an interventional study performed in intensive care units of three teaching hospitals in Tehran, Iran. Thirty and six blood samples of 18 patients were taken for measuring serum cortisol level and physiological indexes during their admission in the critical care settings with restricted visitation. The samples were taken, before family presence and then, one hour after visitation. Simultaneously, blood pressure and heart rate were recorded. The blood samples were immediately centrifuged and plasma stored at 200C until laboratory measuring. Total serum cortisol level was measured using electrochemiluminescence method. Data were analyzed using SPSS version 21.

Findings.Therewasnostatistically significant difference inserumcortisol levels(P=0.70), systolic blood pressure(P=0.93), diastolic blood pressure (P=0.98), and heart rates(P=0.60), before and after visitation.

Conclusion: Family visitation doesn't cause stress. Unlike some common belief about relationship between family presence and stress in patients, it can be concluded that family visitation can be permitted, if patient desires.

Modification and validation of FOUR coma scale

amirhossein pishgooie

Abstract

Aim.The aim of this study was to modify and validate FOUR coma scale.

Background.Critically ill patients admitted to the intensive care unit (ICU) have fluctuating levels of consciousness. It is necessary to have a valid scale to provide an appropriate care of these patients. Presently, the Glasgow coma scale (GCS) is widely used but it has some problems. Recently, the FOUR coma scale proposed to determine the level of consciousness and it is gradually gaining wide acceptance.

Method.This study is a methodological research. After translation and modification of FOUR com scale, the final version used for determining validity. For evaluating convergent construct validity, the original and modified FOUR scale compared with the APACHE II in 15 intensive care unit patients and using 40 critical care nurses by 104 pair-wise ratings.

Findings.Correlation of original and modified FOUR Coma scales with APACHE II was 0.02 and -0.04, respectively. Regression of original and modified FOUR scales with APACHE II was 0.03 and 0.3, respectively.

Conclusion.The FOUR scale doesn't have an item for those intubated patients who are not connected to ventilator. It seems that replacing new item in respiratory section of the scale could increase the validity of FOUR scale.

Second life after angioplasty: a qualitative study

Eesa mohammadi

Abstract

Aim.The aim of this study is to clarify the perception and experience of life in Iranian patients after angioplasty.

Background.Regarding the high prevalence of coronary artery disease and increasing number of patients in Iran, and widespread use of medical procedures such as angioplasty for the treatment and due to multiple challenges during the post-treatment which affect different dimensions of lives of patients, an in-depth understanding of the experiences of patients plays a significant role in improving the quality of their lives.

Method. Qualitative approach with content analysis method was used to conduct the study. Purposeful sampling was used to recruit 20 patients who had experienced angioplasty. Data were collected through semi-structured interviews. The interviews were analyzed using qualitative content analysis method.

Findings. During the process of data analysis, four themes reflected the experience and dimensions of life in patients after angioplasty, which included “rebirth, another opportunity”, “revising lifestyle”, “deciding to modify lifestyle” and “the use of available social support resources”.

Conclusion.The results of this study will enhance our understanding of patients' experiences and this, in turn, can guide health care system to support patient care and planning to promote care and unique counseling programs along with understanding of the real needs of the patients.

Ethics and nursing care for dying patient

Jasmen Shahnazari

Abstract

Aim.This paper introduces important points on nursing care of dying patients.

Background.Death is part of the human life process. Statistics show that the most common causes of death in America are cardiovascular diseases and cancer. Definition of death, nursing care for dying patients and its importance have been the focus of many studies.

Method.This paper reviews the subject death and dying patients, and introduces nursing care and ethical points to be considered for these patients.

Findings.Dying patients experience different stages from denial to acceptance, and caring these patients in physical and psychological aspects is the responsibility of nurses.

Conclusion.When caring dying patients, palliative care must be considered, because other interventions are no longer effective. This care begins from the time a life-threatening condition is diagnosed and continues to recovery or death and grieving.

Environmental monitoring in critical care nursing: An evidence-based design

Moslem Mahdavi-Shahri

Abstract

Aim.The aim of this study was to review the physical and social environment monitoring of the intensive care unit and examine how it affects the physiological status of the patient and family needs.

Background.Knowledge and skill in providing nursing care are the main factors affecting the recovery of patients in the intensive care unit (ICU). While a nurse or nursing unit can possess perfect critical care skills and knowledge, those are not the only factors that influence patient recovery. Including nursing skills in ICU is environmental monitoring and creating a pleasant environment with minimal stress. This monitoring includes control of light, sound, color, landscape, music and social support.

Method.This review was conducted by searching electronic databases and hand searching of library resources. Finding articles and research projects was conducted by using keywords on the internet and relevant sites.

Findings.Improvement of the environment in which care is provided not only helps in the healing process for patients, but also increases employee satisfaction and families affected. Environmental monitoring reduces stressful factors from ICU to rectify the effects of these wards for patients and also, reduces staff stress.

Conclusion.The use of research findings is an important part of improving the quality of care for patients in intensive care units and their families. The ICU setting has the potential to afford patients the best possible opportunity to heal if key stress-reducing elements are incorporated into its physical design. Such elements may reduce noise, offer privacy, add full-spectrum lighting, and assimilate color. As well as considering the physical design, a critical program that integrates the family and other healing measures is essential to the milieu of a healing environment.