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Showing 228 results for : Research

Mahnaz Mayel Afshar, Mohammadziae Totonchi, Feridoun Noohi, Dr Majid Maleki, Neda Shirkhanloo, Hamidreza Pasha, Fatemeh Ahangari, Shahpour Geravandpoor, Ali Fathollahifard,
Volume 11, Issue 1 (3-2022)
Abstract

Abstract
Aim. This study aimed at investigating the obstacles to the implementation of evidence-based care from the perspective of the staff nurses in Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
Background. Evidence-based care plays a crucial role in enhancing the nursing care quality due to the up-to-date care measures and procedures, and the cost-effectiveness for patients. However, there are some obstacle to implement it that should be addressed.
Method. This is a descriptive cross-sectional study conducted on 215 nurses from different departments of Rajaie Cardiovascular Medical and Research Center, Tehran, Iran. They were selected using simple random sampling method. The data collection tool was a questionnaire measuring the obstacles to the implementation of evidence-based care. The collected data were analyzed using descriptive and inferential statistics in SPSS version 20.
Findings. According to the nursing staff, the obstacles to the implementation of evidence-based care in the management dimension were the insufficient number of staff (80 percent), the large number of patients (71 percent), and the lack of motivation in the staff (68 percent) and in the individual-care dimension the obstacles were the lack of enough time for nurses to study the conducted research (72 percent).
Conclusion. The obstacles to the implementation of evidence-based care are in both individual and managerial areas, so it is suggested to correct arrangement of human resources, holding training workshops and meetings, creating interaction with the centers implementing evidence-based care, and using their life experiences considering the available facilities.

Soheil Saeed, Neda Sanaie, Mahbobeh Abdolrahimi,
Volume 11, Issue 1 (3-2022)
Abstract

Abstract
Aim. The present descriptive study was conducted with the aim of evaluating the knowledge and skill of pre-hospital emergency technicians in Neyshabour, Iran, in the management of patients with acute coronary syndrome.
Background. Pre-hospital emergency personnel who have sufficient knowledge and skill to diagnose, giving care and transfer of patients can increase the chance of survival and decrease the possibility of acute and chronic complications of the disease.
Method. In this descriptive cross-sectional study, 126 operational personnel working in the emergency medical center of Neyshabour City, Iran, were recruited by census sampling and participated in the study during a one year period in 2021. The data was collected using a researcher-made questionnaire including demographic information, knowledge level questionnaire, and a pre-hospital emergency personnel skill checklist measuring the management of patients with acute coronary syndrome. The data were analyzed in SPSS version 19 through descriptive statistics.
Findings. The overall knowledge score of the majority of participants in the management of patients with acute coronary syndrome was at a good level (58.7 percent); the highest knowledge score was reported in the interpretation of electrocardiography and the lowest knowledge score was in diagnosing the symptoms of acute coronary syndrome. Finally, the overall skill score of the majority of pre-hospital emergency technicians was at a good level (79.4 percent); the highest skill score was reported in the principles of cardiopulmonary resuscitation and the lowest skill score was in performing cardiac monitoring and detecting arrhythmias.
Conclusion. The majority of pre-hospital emergency technicians had an acceptable level of knowledge and skill in the field of managing patients with acute coronary syndrome, but some skills were far from the desired level. Therefore, due to the importance of strengthening the knowledge and skills of pre-hospital emergency personnel, as the first members of the emergency team dealing with cardiac patients, in the management of patients with acute coronary syndrome, regular training and awareness of updated guidelines are recommended.

Sayed Ehsan Kazemeini, Tahereh Ranjbaripour, Atefeh Nezhad Mohammad Nameghi, Sheida Sodagar, Dr Parisa Peyvandi,
Volume 11, Issue 1 (3-2022)
Abstract

Abstract
Aim. This study was conducted to compare the effect of “mindfulness-based cognitive therapy” and “acceptance and commitment therapy” on fatigue and quality of life in men with heart failure.
Background. Fatigue, as one of the important symptoms and complications of heart failure, affects the quality of life of the patients, their self-care and daily task performance. Mindfulness-based cognitive therapy and acceptance and commitment therapy may have an effect on these problems.    
Method. This research was semi-experimental with a pre-test post-test design and control group within a three-month follow-up period. Forty five men with heart failure were purposefully selected and randomly allocated to two experimental groups and one control group (15 people in each group). Data were collected in three stages using the Iowa Fatigue Scale, and Minnesota Living with Heart Failure Questionnaire. Data analysis was done in SPSS-25 software with mixed analysis of variance test.
Findings. After intervention and in follow-up stages, both mindfulness-based cognitive therapy and acceptance and commitment therapy were effective on fatigue and quality of life in men with heart failure. The follow-up test showed a greater effect of acceptance and commitment therapy on quality of life and no statistically significant difference was found between the experimental groups in terms of effect on fatigue. 
Conclusion. Both interventions, especially acceptance and commitment therapy, can be used as effective interventions on fatigue and quality of life along with medical treatments for men with heart failure in medical centers.      

Elham Nazari, Hooman Bakhshandeh Abkenar, Arash Karimi, Behzad Yousofi Yeganeh, Amin Namdari, Monireh Kamali,
Volume 11, Issue 1 (3-2022)
Abstract

Abstract
Aim. This study was conducted to examine the compliance of the administration of Carbapenems in patients undergoing open heart surgery with antibiotic monitoring guidelines of the Ministry of Health and Medical Education in Iran.
Background. Antibiotic resistance is a significant challenge for healthcare systems and can lead to increased costs, prolonged treatment duration, and higher mortality rates among hospitalized patients.
Methods. This cross-sectional descriptive study included 70 patients (35 women and 35 men) who underwent heart surgery between March 2021 and the end of August 2021 at Shahid Rajaei Heart Hospital in Tehran, Iran. Data were collected through direct patient interactions and reviewing patients' medical records and were analyzed using SPSS software version 26.
Findings. The data revealed that 81 percent of patients received appropriate Carbapenem prescriptions, while 19 percent received an incorrect prescription. The most prescribed antibiotic, with a frequency of 92.9 percent, was Meropenem, and the average number of antibiotics prescribed for each patient was 1.87. The highest rate of Carbapenem prescription was observed in patients with ventilator-induced pneumonia (55.7 percent) and those undergoing coronary artery bypass graft (CABG) surgery (45.7 percent). Approximately 55.7 percent of patients required dose adjustments 72 hours after receiving Carbapenem due to increased creatinine clearance, and 15.7 percent needed to discontinue the drug. The most common causative infection agents were Candida Albicans, Klebsiella Pneumoniae, and Staphylococcus Aureus, respectively.
Conclusion. Antibiotic management programs can limit the irrational use of antibiotics such as Carbapenems and help improve the treatment of infections by preventing the development of antibiotic resistance.

Zahra Karami, Beheshteh Tabarsi, Mrs Firouzeh Moeini,
Volume 11, Issue 1 (3-2022)
Abstract

Abstract
Aim. The aim of the study was to examine the effect of lifestyle education using a mobile phone application on adherence to the treatment regimen in patients with hypertension.
Background. High blood pressure is the most important risk factor for cardiovascular diseases and mortality. Educational applications have provided an effective method for self-care and blood pressure control of patients.
Method. This research is a clinical trial study. The number of samples in control and experimental group was 60 people. In the experimental group, the training was conducted using the mobile application at least three times a week for two months and was followed up during the course through phone calls and virtual networks. In the control group, the usual training of the health center was provided. The degree of adherence to the treatment plan of the patients was measured by a researcher-made questionnaire, before and two weeks after the end of the intervention. Data analysis was done in SPSS version 21 using t-test, multivariate covariance analysis and post-hoc test.
Findings. Comparing the adherence to the treatment program between the two groups after the educational intervention, the mean and standard deviation of the scores of the control and experimental group was 337±22 and 441±20, respectively. There was a statistically significant difference between groups after the intervention in all variables including blood pressure, diet, physical activity, drug regimen, and other domains of compliance with the treatment program (p≤0.0001), which indicated the effectiveness of lifestyle training using a mobile phone application on blood pressure and adherence to the treatment plan.
Conclusion. The use of mobile phone application can be effective and useful for improving and controlling blood pressure among patients with hypertension. Nurses, as one of the most important members of the health care team, can have a direct impact on patients’ quality of life through educational interventions

Mohsen Ziyaeifard, Roghaye Mohammad-Taghi, Rasoul Azarfarin, Reza Abbaszadeh, Mehdi Heidari,
Volume 11, Issue 1 (3-2022)
Abstract

Abstract
Aim. This study aimed to compare the effect of Adaptive Support Ventilation (ASV) and Synchronized Intermittent Mandatory Ventilation-Pressure Support (SIMV-PS) modes on consequence of weaning off patients from mechanical ventilator after coronary artery bypass surgery
Background. The ventilation mode used for respiratory support in patients after coronary artery bypass graft surgery is very important. In addition to avoiding pressure on patient's sternotomy incision, the ventilation mode should also provide the possibility of rapid weaning of patient to avoid complications caused by long-term ventilation.
Method. In a semi-experimental study, 26 patients were ventilated with ASV as the experimental group and 26 patients were ventilated with SIMV-PS mode as the control group after coronary artery bypass graft surgery in Rajaie Cardiovascular Medical and Research Center, Tehran, Iran. Mechanical ventilation time and endotracheal tube removal time, hemodynamic variables, and arterial blood gas analysis were compared between the two groups. Data were analyzed using an independent t-test, repeated measures ANOVA and chi-square.
Findings. Out of 52 patients, 36 (69.2 percent) were male and 16 (30.8 percent) were female. The mean time for the endotracheal tube removal was 89.42±33.83 minutes in the experimental group and 101.53±44.91 minutes in control group, which did not have a statistically significant difference (p=0.843). The mean duration of mechanical ventilation of patients in the experimental group was 483.84±158.153 minutes and in the control group, it was 541.92±257.81 minutes, which were not statistically different (p=0.332).
Conclusion. The use of ASV mode for mechanical ventilation after coronary artery bypass graft did not affect reducing the duration of mechanical ventilation and the time of endotracheal tube removal compared to SIMV-PS mode. Therefore, the use of ASV mode for respiratory support of patients undergoing coronary artery bypass surgery should be considered according to the patient's condition and the nurses' expertise.

Nasim Sedighian, Elham Nomiri, Ali Ghorbani, Shadieh Sadegh Sheykhi,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. The aim of the present study was to investigate the relationship of sleep quality and perceived stress with depression in women with acute myocardial infarction and anxiety symptoms.
Background. Depression is a common disorder with a lifetime prevalence of about 15 percent, and today it is considered the main cause of disability worldwide and ranks fourth among the ten main causes of the global burden of disease, which is characterized by long-term periods, a variety of symptoms. It is accompanied by a high rate of recurrence and many physical and mental disorders.
Method. Descriptive-correlational research design was selected for conducting the study. Statistical population included the women with acute heart attack living in Tehran in year 2022. Seventy people who scored higher than average in the anxiety questionnaire were selected as the research sample. The tools of data collection in this research were anxiety, depression, sleep quality and perceived stress questionnaires.
Findings. The results showed that there was a positive and statistically significant relationship between sleep quality and negative perceived stress and depression, and also a negative and statistically significant relationship was found between positive perceived stress and depression. Sleep quality, negative perceived stress, and positive perceived stress could predict respectively 0.18, 0.20, and 0.08 of changes in depression score.
Conclusions. Sleep problems can cause psychological distress and decrease concentration in people, so it can be expected that an increase in sleep problems can reduce a person's energy, and by increasing anxiety, it can cause an increase in psychological problems such as depression. Therefore, people who suffer from heart disease often endure a high level of anxiety due to the risk of the disease, which can be associated with increased sleep problems, thus leading to depression in them.

Akram Sharifi, Forouzan Rostami, Kamiyan Khazaei,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. The purpose of this study was to investigate the effect of mindfulness training on Corona anxiety in patients with Covid-19 and underlying cardiovascular disease in Imam Ali Hospital, Amol, Iran.
Background. Since its outbreak, the corona virus has shown that it defeats more people with underlying diseases and puts them at risk of death than those who have a healthy body.
Method. This was a quasi-experimental study with control group. The accecible population of this research was all corona patients with a history of cardiovascular disease in Imam Ali Hospital, Amol, Iran, in 2021-2022. Sampling was done from the patients admitted to the hospital based on convenience sampling method. To collect information, the Corona Virus Anxiety Questionnaire developed by Alipour et al. (2018) was used. Mindfulness training based on Kabat-Zinn (2005) educational plan was implemented in experimental group in 8 sessions of 2-hour duration per week.
Findings. The results of multivariate covariance analysis showed that mindfulness training has an effect on reducing anxiety of Corona in patients with Covid-19 and underlying cardiovascular disease to the extent of 0.87 (p≤0.001). Univariate covariance analysis showed that mindfulness training has an effect on reducing the mental symptoms of Corona anxiety in patients with Covid-19 and underlying cardiovascular disease to the extent of 0.83 (p≤0.001). Also, mindfulness training has an effect on reducing physical symptoms of Corona anxiety in patients with Covid-19 and underlying cardiovascular disease by 0.79 (p≤0.001).
Conclusion. Mindfulness exercises can enable patients with Covid-19 and underlying cardiovascular disease to pause and reflect a little before responding, and these pauses provide them with an opportunity. It allows them to get rid of judgment in many situations that can lead to anger, fear and anxiety. This will provide conditions that patients, even in the worst and acute state of their illness, are more likely to be able to maintain their mental peace and thereby, reduce the physical signs and symptoms of anxiety.

Hanieh Aghakhani, Zahra Behpour, Zahra Amirsardari, Mohammad Esmaeil Zanganehfar, Melody Farrashi, Hooman Bakhshandeh, Parham Sadeghipour, Hojjat Mortezaeian, Abolfath Alizadeh, Bahador Baharestani,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. This study aimed at examining the convergence of calculated HEART pathway by physician and nurse along its utility to predict the 3-month occurrence of major adverse cardiac even (MACE) in patients with chest pain admitted to emergency department (ED).
Background. The HEART pathway is a tool to predict MACE in patients with chest pain admitted to ED, to help risk stratification for early discharge and reduce unnecessary cardiac tests.
Method. In the present study, a diagnostic tool was evaluated. Ninety-seven ED patients with acute chest pain, hospitalized in Rajaie Cardiovascular Medical and Research Center, were recruited prospectively. Risk stratification was performed by an ED nurse, a cardiology resident, and a cardiology attending physician. The correlation and the 3-month MACE outcomes were analyzed. 
Findings. Pairwise agreements were excellent between the raters. The Intraclass Correlation Coefficient (ICC) among raters were 0.84 (95% CI: 0.73–0.97) and thus, overall agreement was excellent. The HEART pathway score showed a high predictive power (AUC: 0.85 for 3-month MACE). For a cut-off score of 4, sensitivity, specificity, and negative predictive values were 87.5, 58.9, and 95.8 percent, respectively.
Conclusion. The HEART pathway score predicted effectively 3-month MACE in patients with acute non-traumatic chest pain. The high agreement among the three different raters suggests that nurses might use efficiently the score.

Naser Javadi, Mohsen Taghadosi, Mansour Dianati,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. This study was designed to identify factors affecting lifestyle modification in people with ischemic heart disease.
Background. Lifestyle is an important determinant of health. The relationship between lifestyle and various diseases has been reported in many studies. Ischemic heart disease is one of the most important diseases related to lifestyle, which causes significant morbidity and mortality in societies. Understanding the factors affecting the lifestyle modification of people with ischemic heart disease can reduce the complications caused by this condition.
Method. This integrated review with the seven-step method of Dhollande et al. (2021), searching for effective factors on lifestyle modification in people with heart ischemia in Persian and English language articles published from January 2013 to March 2024. The keywords included lifestyle, modification, change, ischemic heart disease, coronary heart disease, inhibiting factors and facilitating factors, which were searched out in databases including PubMed, Scopus, Science Direct, Web of Sciences, Magiran and SID. A total of 2753 articles were obtained, and finally 20 articles were selected and reviewed in this study.
Findings. The review of studies showed that 19 articles are in English and one article is in Farsi. The number of participants in all selected studies was 738809. Eight studies were conducted with qualitative method, eight with quantitative observational designs and four with clinical trial design. Also, 12 studies were conducted in European countries, while eight were conducted in Asian countries. The themes of the articles were obtained in the form of demographics, socio-economic, political-organizational, psychological-learning and individual-belief factors.
Conclusion. Lifestyle modification in people with ischemic heart disease is a complex and multidimensional process. Holistic support for these patients is necessary to modify their lifestyle. Understanding these factors is a basis for improving care programs for these patients.

Soroosh Golestanifar, Zahra Dashtbozorgi, Parviz Asgari, Alireza Heidari,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. This study was conducted with the aim of determining the effect of emotion-focused couple therapy on marital life quality, covert relational aggression and psychological health of couples with cardiovascular disease.
Background. Patients with cardiovascular disease face many problems in their marital life and psychological health, and the use of couple therapy methods is necessary to improve them.
Method. This study was a semi-experimental pretest-posttest design with control group. The study population was patients with cardiovascular disease (including hypertension, acute coronary syndrome, infarction, angina pectoris and constrictive pericarditis) referred to Razi Hospital in Ahvaz city, Iran in 2023. The sample size for each group was considered to be 13 couples, and these couples were selected by purposive sampling method based on inclusion criteria. The experimental group received 8 sessions of 90 minutes duration (two sessions per week) in the form of emotion-focused couple therapy and during this time, the control group did not receive any intervention. Data were collected with the scales marital life quality (Zhang et al., 2013), covert relational aggression (Nelsno & Carroll, 2006) and psychological health (Najarian & Davoodi, 2001) and were analyzed with Chi-square test, independent t-test and multivariate analysis of covariance in SPSS-26 software.
Findings. There was no statistically significant difference between the experimental and control groups in terms of age, education, illness duration and type of couple illness. In the pre-test stage, the groups did not differ significantly in terms of the mean score of marital life quality, covert relational aggression and psychological health, but in the post-test stage, there was a statistically significant difference in the mean score of all three variables (P≤0.0001). In this way, the emotion-focused couple therapy improved married life quality (F=125.366, P≤0.0001), reduced covert relational aggression (F=206.601, P≤0.0001) and improved psychological health (F=175.052, P≤0.0001) in couples with cardiovascular disease.
Conclusion. The results of this study showed the effect of emotion-focused couple therapy on improving the marital life quality, reducing the covert relational aggression, and improving the psychological health of couples with cardiovascular disease. Therefore, counselors and therapists can use emotion-focused couple therapy along with other effective treatment methods to improve variables related to marital life and psychological health.
 

Shiva Khaleghparast, Leyla Abdolkarimi, Monireh Kamali, Hamidreza Pouraliakbar, Masoumeh Rostami, Neda Shirkhanloo, Hamidreza Pasha, Fahimeh Farrokhzadeh, Samaneh Karimian, Saeideh Mazloomzadeh,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. This study examines the relationship of COVID-19 infection with demographic characteristics of the staff at Rajaie Cardiovascular Institute during the first six months of the epidemic.
Background. The COVID-19 virus was first identified in December 2019 in China and then rapidly spread to other countries. One of the challenges that arose during the COVID-19 pandemic was human resource management. This led managers to prioritize protecting and managing employee health and safety.
Method. This descriptive-analytical study was conducted on the staff of the Rajaei Cardiovascular Institute who were infected with COVID-19 between February and September 22, 2020. Demographic characteristics and clinical variables of the patients were collected using clinical records, interviews with the infected individuals, and phone calls. Data analysis was performed using SPSS software version 22.

Findings. Over six months, 448 individuals with a mean age of 38.86 years contracted COVID-19. Among them, 280 individuals (62.5 percent) were female. A total of 155 employees (67.1 percent) developed symptoms of the disease within one to five days after contact with an infected person. Additionally, 206 employees (48.4 percent) used all three protective measures—masks, gloves, and social distancing. Contact with an infected individual was observed as the most common method of disease transmission. The most common symptoms among the infected were myalgia, weakness, and fever, with only 3.5 percent requiring hospitalization.
Conclusion. Most patients, despite following health and personal protection guidelines, contracted COVID-19. Therefore, it seems that in addition to adhering to health guidelines,  vaccination is also an important necessity to prevent the spread of COVID-19. Other factors, such as changes in virus strains and people's failure in following health protocols, also contribute to the spread of the disease.

Sahar Tavan, Nehleh Parandavar, Rasool Eslami Akbar, Mohsen Hojat, Mohammad Hashem Abdi,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. The purpose of this study was to examine the effect of wearing personal protective equipment against covid-19 during cardiopulmonary resuscitation on physiological measures and fatigue in student nurses.
Background. Exposure of health workers to respiratory secretions and droplets of patients causes many infections. The use of personal protective equipment by nurses, despite providing safety, is often described as uncomfortable.
Method. The current randomized controlled trial was conducted in practical nursing skills laboratory of nursing school affiliated to Jahrom University of Medical Sciences in 2022. Student nurses studying at eight semester were recruited in the study by census sampling method and randomly allocated to either experimental or control group. Intervention was wearing PPE during CPR for experimental group (n=20) compared to the control group (n=20) not wearing PPE. Physiological measures (pulse rate, blood pressure, oxygen saturation percentage, and temperature) and fatigue index was measured before and after intervention. Data were analyzed using descriptive and inferential statistics in SPSS version 21.
Findings. Before intervention, there was no statistically significant difference between groups in heart rate, average systolic and diastolic blood pressure, percentage of oxygen saturation, fever and fatigue. After intervention, the means of pulse rate (p≤0.0001), systolic blood pressure (p=0.035), temperature (p≤0.0001), and fatigue score (p≤0.0001) in experimental group were significantly higher than the control group. The mean percentage of oxygen saturation after the intervention was not significantly different between the groups.
Conclusion. The use of personal protective equipment during cardiopulmonary resuscitation can affect physiological measures including blood pressure, pulse rate, and temperature, and fatigue in student nurses. It is necessary to design personal protective equipment with minimal potential discomfort and the highest safety for healthcare providers.

Dr Mahsa Boozari Pour, Miss Zohreh Shahbazi, Dr Neda Sanaie, Dr Sepide Jafari Naeinie,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. The aim of this study was to examine the effect of telemonitoring on the compliance with self-care recommendations in patients with heart failure.
Background. Patients with heart failure need to strengthen their self-care behaviors in order to cope with the problems caused by the disease. This is despite the fact that most patients have poor compliance with self-care recommendations. In recent years, telemonitoring has been considered as an effective approach to increase patients compliance with self-care recommendations.
Method. This was a quasi-experimental study with an intervention group. The desired outcome was adherence to weekly self-reporting of three subjects: vital signs, questions related to experienced symptoms related to the disease and questions related to educational content. The statistical sample consisted of 68 people with heart failure referred to the heart failure clinic of selected hospitals in Tehran, Iran, who were selected by available methods and were trained and followed up for 8 weeks through messengers and phone calls.
Findings. Out of 68 patients, 7 patients were excluded, and the data of 61 patients was analyzed and reported as percentage of frequency. This method of intervention has received very good feedback from the participants such that the average response to questions related to weekly educational content was 91.9 percent, the average weekly self-reporting of vital signs was 86.4 percent, and the average weekly response to questions related to symptoms experienced related to the disease was 93 percent.
Conclusion. The results show that telemonitoring is effective in increasing the compliance with self-care recommendations in patients with heart failure.

Mahdi Hedayat, Maryam Moghimian, Raziyeh Amini,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. This study aimed to examine the effect of implementing a risk management program on pharmaceutical calculation skills of nurses in cardiac care units.
Background. Patient safety and the early detection of medication errors are indicators of the quality of care. Risk management, through a systems-based approach, is an important strategy for preventing medication errors and harm to patients.
Method. This was a semi-experimental study. The study population was staff nurses working in the cardiac care units of Milad Hospital in Isfahan. Sixty nurses working in cardiac care units were selected based on inclusion criteria using a convenience sampling method, and they were randomly assigned to experimental and control groups. The intervention group participated in a risk management program delivered in eight 2-hour sessions, two sessions per week. The control group received the hospital training program. Data collection instruments included demographic form and nurses’ pharmaceutical calculation skills questionnaire, which were completed at the beginning and two weeks after the study. Data were analyzed in SPSS 21.
Findings. Before the study, there were no statistical significant differences between the two groups in pharmaceutical calculation skills, interest, ability, need for training, ease of pharmaceutical calculation skills, and medication errors. The mean score of the pharmaceutical calculation skills was in the “good” level. After the study, in the intervention group the nurses’ pharmaceutical calculation skills, ease of calculations, and ability increased significantly (p≤0.0001), whereas there was no significant change in the control group. After the study, the difference in pharmaceutical calculation skills between the intervention and control groups was significant (p≤0.0001).
Conclusion. Implementation of the risk management program significantly enhances nurses’ pharmaceutical calculation skills and is suggested as a strategy for promoting safe medication administration by nurses and achieving high-quality nursing care.
 

Niloofar Ahmadi, Masood Rezaei, Mohammadreza Zarei, Shima Haghani , Fatemeh Rashidi, Mohammad Abbasi,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. This study aims to assess the impact of education based on the Pender’s health promotion model on quality of life and medication adherence in patients with implantable cardioverter defibrillator (ICD).
Background. Heart failure is a chronic condition in which the heart is unable to provide adequate circulation to meet the metabolic needs. One of the common complications of this disease is sudden cardiac death due to
arrhythmias. Implantable cardioverter defibrillators (ICDs) are recognized as an effective treatment for this issue, as they detect life-threatening arrhythmias and deliver electrical shocks to restore the heart's rhythm to a normal sinus rhythm. Despite the life-saving benefits of these devices, ICD shocks may have negative effects on patients' quality of life. Additionally, poor medication adherence remains a major challenge, leading to treatment failure, increased complications, and higher healthcare costs. Through the implementation of various educational models and health strategies, nurses can effectively influence patients' awareness, attitudes, and health behaviors. The Pender’s Health Promotion Model (HPM) is a framework that leverages individuals' experiences, emotions, perceptions, and
behaviors to improve health outcomes.
Method. This is a study protocol for a randomized clinical trial that will be conducted at Shahid Rajaei Cardiovascular Institute in Tehran. Patients with heart failure who undergo ICD implantation will be randomly assigned to the intervention and control group. Both groups will complete a demographic information form, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Morisky Medication Adherence Scale (MMAS-8). The intervention group, in addition to receiving the standard hospital educational program, will
participate in a 45-minute in-person session at discharge. This session will introduce the number and content of the educational sessions and emphasize the importance of continuous participation. Subsequently, five 30-minute virtual educational sessions will be conducted twice weekly, based on the Pender’s Health Promotion Model. Additionally,
weekly telephone follow-ups will be conducted for one month to monitor adherence to recommendations and address potential issues. The control group will receive only the standard hospital education program at discharge. At the end of the study, both groups will complete the MLHFQ and MMAS-8 questionnaires again to assess outcomes.
Yaser Saeid, Abbas Ebadi, Hosein Mohammadi Roshan, Seyed Mohammad Saeid Ghiasi, Mohamad Hasan Kalantar, Seyed Tayeb Moradian,
Volume 13, Issue 1 (3-2024)
Abstract

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.

Alireza Moradi, Jafar Hassani, Mahmoud Borjali, , Bayane , Abdollah Zadeh,
Volume 13, Issue 1 (3-2024)
Abstract

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.
 

Sara Hakimzadeh, Hamid Peyrovi, Bibi Esmat Hosseini , Hamid Haghani,
Volume 13, Issue 1 (3-2024)
Abstract

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.

Alireza Saberi Aliabad , Zahra Alizadeh, Amirreza Rafiei Javazm, Alice Khachian , Masoud Roudbari, Mohammad Reza Zarei,
Volume 13, Issue 1 (3-2024)
Abstract

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.


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فصلنامه پرستاری قلب و عروق Iranian Journal of Cardiovascular Nursing
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