Abstract
Aim. The present study aims to determine the performance of “Tehran 115 medical emergency” dispatchers in providing services to patients with chest pain.
Background. Chest pain is one of the most common problems for which individuals call medical emergency services. The pace, accuracy, and integration of services by medical emergency dispatchers are highly important to decrease mortality and disability rates.
Method. A cross-sectional descriptive study was carried out on 397 voice records of 80 dispatchers in “Tehran 115 medical emergency services” about chest pain in January 2019. Data gathering was done using the Dispatcher Performance Assessment Checklist. All the obtained scores by the checklist were analyzed in SPSS (V.22).
Findings. All voice records demonstrated an acceptable performance of the dispatchers. The mean score of performance in consultation section was 18±2.66 ranged from 9 to 20. The mean score of performance in key questions section was 35.95±2.16 with a score range from 28 to 38. The total mean score of performance was 53.95±3.57 with a score range from 43 to 58. In addition, employment status (P=0.039) and work experience (P=0.020) were significantly related to dispatchers’ performance in terms of assessing chest pain.
Conclusion. Assessment according to the checklist items and provision of proper consultation services to the patients and patient companions by the 115 dispatchers resulted in a better and timely diagnosis, faster dispatch of ambulance, less damages sustained by heart patients, and prevention of death. The findings emphasized on the necessity of adhering to the questions algorithm and uniform work procedure by dispatchers nationwide. This should be an integral part of telephone triage. Observation of national standard prevents probable damages to patients due to wrong or personalized decision making.

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.