Abstract
Aim. The aim of this study was to examine the effect of self-management training and follow-up with phone calls or mobile social network on the blood pressure of people with hypertension.
Background. Hypertension is one of the main causes of preventable death worldwide, and self-management training and follow-up is of particular importance in these patients.
Method. This randomized controlled clinical trial was conducted on 100 patients with primary hypertension referred to AL-Zahra hospital, Isfahan, Iran in 2016. The patients were recruited through convenience sampling and were allocated by blocking randomization into four groups, control group, “self-management education without follow-up” group, “self-management education by social network follow-up” group (education and weekly follow-up for 6 weeks) and “self-management education by telephone follow-up” group (education along with weekly calls for 6 weeks). Data were collected before and 6 weeks after intervention. The data were analyzed using Chi-square test, ANOVA, and paired t-test in SPSS, version 16.
Findings. After intervention, the study groups were significantly different in terms of blood pressure (P ≤0.0001). According to Scheffe post hoc test, intervention groups (with and without follow-up) had a statistically significant difference regarding to the blood pressure when compared with compared with the control group (P≤0.0001). Scheffe post hoc test results showed that three interventions (education without follow-up, education with telephone follow-up and education with social networks follow-up) did not differ in terms of effect on systolic and diastolic blood pressure.
Conclusion. Self-management training and follow-up by telephone or mobile social network were effective on the blood pressure of people with hypertension. Nurses can take a positive step towards improving the management of hypertension with a comprehensive patient education and follow-up.

Abstract
Aim. The aim of this study was to determine the effect of the implementation of clinical surveillance model on the amount of education provided to cardiac patients.
Background. Clinical supervision is a relationship between nurse and observer that promotes the development of nursing professional skills.
Method. This is a quasi-experimental before-after study without control group. The stratified sampling method was used to recruit 300 patients based on inclusion and exclusion criteria. The researcher used the data-gathering form to record teachings provided to patients by nurses and also, the rate of their registration in the medical record. Clinical surveillance model included planning, monthly meetings with health education volunteers, classified teaching, daily clinical supervision, follow-up, identifying the weaknesses of nurses in providing training to cardiac patients and corrective actions in a regular and continuous basis for one year. After the intervention, teachings provided to patients by nurses and also, the rate of their registration in the medical record were re-evaluated. Data were analyzed using descriptive and inferential statistics in SPSS version 19.
Findings. After intervention, the amount of teaching provided by nurses at the time of admission, during hospitalization and at the time of discharge was significantly increased (P<0.001). The findings also showed that the patients were more satisfied with the received teaching after intervention (P<0.001).
Conclusion. Continuous and regular monitoring has a significant role in the amount of education provided to patients by nurses. It is recommended to plan management and supervisory programs to be implemented for nurses involved in patient education.

Abstract
Aim. This study aimed to examine the effect of participation-based education program on nurses' knowledge and practice of critical care nurses about central venous catheter care in intensive care units in teaching hospitals of Zanjan University of Medical Sciences, Iran.
Background. Improving the quality care of central venous catheters requires the promotion of nurses’ knowledge of standard guidelines and manuals of catheter care and also the knowledge of latest findings in this field.
Method. In this quasi-experimental study with pretest-posttest design, 46 nurses working in intense care unit of two teaching hospitals (Ayatollah Mousavi and Vali-e-Asr hospital) were recruited into experimental group (n=28) and control group (n=18). Before intervention, nurses' knowledge and performance regarding central venous catheter care were measured by the questionnaire developed by Labio et al. in 2008 and a researcher-made observational checklist. Then, educational intervention based on participation was implemented for the experimental group for 1 month, and routine intervention (taking part in one session lecture) was also carried out for the control group. Three months after intervention, nurses' knowledge and performance were measured again through questionnaire and checklist by the co-researcher. Data were analyzed by SPSS (version 16) utilizing Chi-square, Fisher, ANOVA, and independent t-test and paired-sample t- test.
Findings. After intervention, there was a statistically significant difference between experimental and control group in mean change of knowledge score (experimental group, 2.82 against control group, 1.67)(p=0.004) and performance score (experimental group, 11.69 against control group, 10.85) (p≤0.0001) about central venous catheter care.
Conclusion. Educational intervention based on participation is more effective than the other conventional retraining programs in improving the nurses' knowledge and performance about central venous catheter care. It is suggested to apply participation-based education program for in-service training.

Abstract         
Aim. This study aimed to determine the relationship between self-care behaviors and readmission in people with heart failure.
Background. People with heart failure are frequently hospitalized due to worsening symptoms. Admission to hospital reduces quality of life of patients, also imposes large costs for them. To control this disease, adherence to self-care behaviors is important.
Method. In this descriptive analytical study, 245 heart failure patients with the history of readmission were recruited with convenience sampling method from Taleghani and Syedalshohada teaching hospitals of Urmia, in 2016. Data collection tool included self-care heart failure Index. Data were analyzed by descriptive and inferential statistics using SPSS.
Findings. Self-care mean score in participants was 45.59±7.6 and most patients had a moderate level of self-care behaviors. Pearson correlation coefficient showed a reverse statistically significant correlation between self-care score with the number of hospitalization (r=-223, p≤0.0001).
Conclusion. Self-care behaviors of the majority of patients was not favorable in terms of quality and there was a reverse correlation between self-care behaviors and readmission, It is suggested further investigating the factors affecting self-care behaviors and taking actions to deal with these factors.

Abstract
Aim. The aim of this study was to examine the effect of changing position on back pain after cardiac catheterization.
Background. Prolonged bed rest after coronary angiography produces back pain.
Methods. This was a quasi-experimental study conducted on 98 patients who had been admitted for coronary angiography in Shahid Beheshti Hospital of Kashan, Iran, in the year 2014. Patients were randomly allocated to intervention and control group. In this study, data collection form consisted of three sections including demographic information, numerical pain scale, and bleeding and hematoma control checklist. Patients in the control group received routine care after coronary angiography including bed rest for 6 hours without movement of effected limb. However, patients’ position in the intervention group was intermittently changed during the first 6 hours after catheterization. Patients in the intervention and control group were assessed in terms of severity of pain, and bleeding and hematoma, immediately after moving to the ward, and then two, four and six hours after angiography. The data were analyzed in SPSS version 11.5 using descriptive and inferential statistics.
Findings. The result showed that there were statistically significant differences between the intervention and control group in terms of mean score of back pain immediately after moving to the ward (p≤0.0001), and 4 hours (p≤0.0001) and 6 hours (p≤0.0001) after angiography.
Conclusion. In this study, changing position of patients after angiography reduced back pain in patients without causing any complication like hematoma and bleeding; therefore, it can be concluded that applying this intervention could be considered as a convenient way to relieve back pain in patients after coronary angiography.

Abstract
Aim. The aim of this study was to compare the quality of life in military and non-military people with and without hypertension.
Background. Hypertension is one of the most important causes of chronic disability in the world that its progressive course may affects various aspects of quality of life.
Method. This was a cross-sectional study with a descriptive comparative design in which 200 men with hypertension (100 military and 100 non-military) and 200 men without hypertension (100 military and 100 non-military)  were recruited to the study by convenience sampling method in Tehran. Data were collected by short form (SF36) quality of life questionnaire and demographic form.
Findings. The mean score of quality of life in the group of people without hypertension (military people, 82.20±12.72; non-military people, 84.83±8.01) were significantly higher than the group with hypertension (military people, 76.72±16.60; non-military people, 68.58±17.77)
Conclusions. Quality of life in military and non-military men with hypertension is lower than the military and non-military men without hypertension. It is necessary to pay more attention to people with hypertension for promoting their quality of life.

Abstract
Aim. This study was carried out to compare the effect of trinitroglycerin (TNG) spray and sublingual pearl on chest pain severity and some physiological indices of people with chest pain visited by emergency medical services.
Background. Glyceryl trinitrate is used as an anti-anginal vasodilating agent with various forms including spray and pearl with probable different therapeutic effects.
Method. In this quasi-experimental study, 80 patients with chest pain were recruited through convenience sampling and then allocated to pearl and spray groups by minimization method. After arriving at the patient's bedside, vital signs and chest pain severity were measured and recorded, then the drug was administered every 5 minutes for 3 times; thereafter, the measurements were repeated. The data analyzed in SPSS software 1) using descriptive and inferential statistics.
Findings. The results showed that after intervention, the mean score of pain in pearl and spray groups were 6.05±0.98 and 5.60±1.25, respectively. There was no statistically significant difference between groups in terms of pain score. Whereas after intervention, the mean systolic and diastolic pressure in pearl group was significantly lower than the spray group, the heart rate in both groups were increased.  
Conclusion. Nitroglycerin in the pearl form has the same effect as spray form in relieving chest pain. According to the circumstances and drug accessibility, emergency staff might use every two forms of Nitroglycerin.

Abstract
Aim. This study compares the effect of foot reflexology and stroke massage on depression in people with acute myocardial infarction.
Background. Depression is a common complication of myocardial infarction and could increase the likelihood of further attacks. Medication as a common therapy for treating depression has many side effects. So interventions performed with minimal risk is of great importance when managing depression in these people.
Method. In this randomized clinical trial (IRCT2016060817756N2), 60 people with myocardial infarction, admitted to CCU in Valiasr hospital in Birjand, were selected using convenience sampling and randomly allocated into three groups; intervention with reflexology (n=20), intervention with stroke massage (n=20),  and control group (n=20). Massage therapy was implemented for 5 weeks (three days a week) . Data collection tool was Beck Depression Inventory. Beck Depression Inventory was completed before and after intervention by participants in all three groups. Data were analyzed in SPSS 16 software using Chi-square test, t-test, ANOVA and Tukey.
Findings. Before intervention, there was no statistically significant difference between the groups in the mean score of depression (p=0.453), but a statistically significant difference was found after intervention (p <0.001). Tukey's post hoc test showed that after intervention, the mean scores of depression significantly decreased in foot reflexology group (23.65±3.50) compared with that of stroke massage   group (27.55±3.42) (p=0.006) and  control group (30.05±4.50) (p<0.001), but not statistically significant difference seen between stroke massage and control groups in terms of mean score of depression. Changes in mean depression scores before and after intervention was significantly higher in the foot reflexology massage group compared with stroke massage and control groups, and also, these changes was significantly higher in the stroke massage group compared with control group.
Conclusion. Both types of massage were effective in reducing depression, and the effect of the foot reflexology was greater. So, it is recommended to apply these interventions in routine nursing care for people with myocardial infarction experiencing depression.

Abstract
Aim. This study aimed to investigate the effects of a Turkish, family-oriented multimedia application on adherence to therapeutic regimen in people with recent myocardial infarction.
Background. Using native language in education of people experiencing myocardial infarction may have an effect on their adherence to therapeutic regimen.
Method. This study is a clinical trial. The research was conducted in Post-CCU wards of Zanjan hospitals in 2016. In this study, 80 patient with myocardial infarction were randomly allocated to experimental  (n=40) and control (n=40) group during a 6 month period. Data collection tools consisted of demographic form and a questionnaire measuring adherence to therapeutic regimen in domains diet, physical activity, and medication. Data were analyzed in SPSS V.20 by statistical tests (Chi-square, Mann-Whitney and T-Test.
Findings. Comparison of the groups indicated a statistical significant difference between the mean score change of adherence to medication regimen of experimental and control group (3.52±0.2 versus 2.79±0.73) (P≤0.0001), adherence to diet (3.91±0.3 versus 3.63±0.6) (P≤0.0001), and adherence to physical activity (3.57±0.4 versus 3.11±0.7) (P≤0.0001).
Conclusion. Family-centered family education through multimedia application (in Turkish) is effective on patients’ adherence to therapeutic regimen and in turn, may reduces the costs and complications.

Abstract
Aim. This study aimed to evaluate the perceptions of nurses working in intensive care units about obstacles and supportive behaviors of end of life care.
Background. End of life care is an important part of nursing duties in intensive care units. Exploring supportive behaviors of end of life care from the perspective of nurses may lead to better understanding of supportive behaviors and obstacles of end of life care.
Method. This study was a descriptive cross-sectional study in which 160 staff nurses, working in intensive care units in Rajaei Cardiovascular Medical and Research Center, were recruited by random sampling in 2016. Data were collected using demographic form and the questionnaire “National Survey of Critical-Care Nurses Regarding End-of-Life Care” (NSCCNR-EOL) and analyzed in SPSS version 22 software using descriptive statistics.
Findings. The most important obstacle in end-of-life care was "family and friends who continually call the nurse wanting an update on the patient's". In the field of supportive care, "After the patient's death, having support staff compile all the necessary paper work for you" received the highest score.
Conclusion. Based on the findings, in critical care nurses views, appropriate training on end-of-life care and palliative care for staff, educating families about issues of death and dying, and the holistic care of patients and their families improve end-of-life care of dying patients.