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Tahereh Dehghani Firouzabadi, Alieh Dehghani Firouzabadi, Mohammad Hossein Dehghani Firouzabadi,
Volume 11, Issue 1 (3-2022)
Abstract

Abstract
Aim. The aim of this study was to examine the effect of treatment based on choice theory (reality therapy) on self-efficacy of people with hypertension.
Background. Hypertension and its complications leads to high mortality and therefore, is considered as a major health problem affecting individual self-efficacy. In addition to drug therapy, psychological treatments can be a significant and important prerequisite for behavior change and self-care promotion in people with hypertension.
Method. The present study was quasi-experimental with a pretest-posttest design and control group. The statistical population of the study included all people with high blood pressure under coverage of the health centers of Meybod city Yazd province) in the fall-winter 2018, who were recruited in the study based on convenience sampling (n=30) and were randomly allocated to experimental and control group. The samples responded to the self-efficacy questionnaire of hypertensive patients (DMSES) before and after intervention. The treatment program based on choice theory was carried out in 8 sessions. The data were analyzed by covariance analysis according to the research hypothesis.
Findings. The results showed that after controlling for the pre-test effect, there was a statistically significant difference between the post-test self-efficacy scores of the group. After the treatment based on the selection theory, the scores of the dimensions of diet, physical activity, drug consumption and blood pressure control of patients with hypertension increased significantly in experimental group compared with the control group.
Conclusion. Implementation of treatment based on choice theory can be a suitable method for increasing self-efficacy in people with hypertension. It's suggested that by applying the theory-based treatment of choice for people with hypertension, an effective step can be taken to improve their self-efficacy.
 

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.

Zoleikha Abbasi, Mohammad Javadinejad, Mahbubeh Shali, Elham Navab,
Volume 11, Issue 1 (3-2022)
Abstract

Abstract
Aim. This review study was conducted with the aim of highlighting the importance of a preoperative preventive approach in the recovery of patients undergoing coronary artery bypass surgery.
Background. With the increase in the number of patients who are candidated for heart surgery, improving the health status before the operation is of great importance to optimize the results after the operation. This review has been conducted with the aim of evaluating the evidence related to the pre-rehabilitation of patients undergoing coronary artery bypass surgery.
Method. The present literature review was conducted by searching out library resources and databases, Scopus, Chochrane Library, Magiran, SID, PubMed, Up-to-date, OVID, CINAHL, and Web of Science with the keywords, coronary artery bypass surgery, pre-rehabilitation, cardiovascular disease and their Persian equivalents without time limit. From a total of 104 articles, 63 full texts articles entered the review stage, of which 17 articles entered the literature review.
Findings. The findings indicate the favorable effects of pre-rehabilitation on improving the quality of life and preventing complications in the early postoperative period. Pre-rehabilitation programs should adopt multifaceted approaches including nutrition, exercise, and anxiety reduction to improve patient resilience in the preoperative period. The pre-operative period is a critical opportunity to implement pre-rehabilitation interventions for vulnerable patients awaiting cardiac surgery.
Conclusion. Cardiac pre-rehabilitation includes a wide range of preventive interventions that can be taught by nurses to patients undergoing cardiac surgery. Pre-rehabilitation requires an interdisciplinary approach, because it suggests a change from the current model of health care and transformation from one-dimensional care to interdisciplinary care, which can be an effective tool for the medical and nursing system in timely identification of physical and mental disorders in initial preoperative assessment, preoperative education and management, as well as prevention of postoperative complications.

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.

Jasem Allahyari, Farnaz Jahantigh, Benyamin Saadatifar, Javad Jafari, Mohammad Sadegh Sargolzaei,
Volume 11, Issue 1 (3-2022)
Abstract

Abstract
Aim. This literature review was conducted to investigate determinants of readmission among Iranian people with heart failure.
Background. Heart failure (HF) as a chronic progressive syndrome may reduce the quality of life and increase their treatment costs. The rate of readmission is relatively high in these patients, presenting a major health problem.
Method. In the present literature review, the literature on the topic were searched out in databases PubMed, Google Scholar, Web of Science, ProQuest, Magiran, SID, and IranMedex. The terms heart failure, congestive heart failure, readmission, rehospitalization, and Iran were searched without time limit. Literature search and evaluating the articles were independently conducted by two researchers, and all eligible studies were included in the review process.
Findings. Out of 601 studies found in the initial search, seven articles meeting the inclusion criteria entered the final phase of the study and were reviewed. According to these studies, the readmission rate varied from 10.9 to 40 percent. Some of the important factors affecting the readmission rate in patients with heart failure included age, gender, education, job status, underlying disease, disease stage, poor adherence to the therapeutic regimen, insurance coverage status, and place of residence.
Conclusion. Based on the results of the present study, the rate of readmission was high among Iranian patients with heart failure. It is recommended to consider interventions such as educational programs to improve patients’ awareness about this condition and their adherence to self-care activities.

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

Esmaeil Mohammadnejad,
Volume 11, Issue 1 (3-2022)
Abstract

Abstract
Aim. In this review article, the cost-effectiveness of disposable suction bottles in Iran was discussed.
Background. Healthcare-associated infections (HAIs) cause mortality and morbidity in patients, especially in the intensive care unit. There are different methods and instructions to control HAI, which is an important and fundamental problem related to suction.
Method. Searching out for articles through databases including Science Direct, PubMed, Cochrane, Medline, SID, Scopus, CINAHL, OVID, Iran Doc and Magiran using the keywords "disposable suction", "hospital infection", "waste management" and their English equivalent were conducted. Articles that were published between 2000 and 2022 and were more related to the main focus of the research topic were selected. The inclusion criteria included their publication in reputable scientific journals, publication in Farsi or English, and access to the full text of the article. Exclusion criteria included publishing articles in weak and invalid journals.
Findings. Disposable suction bottles was evaluated in five domain including hospital infection control and prevention, water consumption management, ease of use, waste management, and cost effectiveness.
Conclusion. Considering the lack of manpower for disinfecting disposable suction bottles, the costs of disinfectant solutions and their improper use in diluting them, and the management of waste water from used solutions and emptying suction cups; disposable suction bottles have priority over reusable suction bottles in Iran.

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.

Parisa Bozorgzad, Maryam Ehsani, Mohammadreza Zarei,
Volume 11, Issue 1 (3-2022)
Abstract

Abstract
Aim. This paper aims to investigate barriers and opportunities of the virtual visiting in intensive care unit during Covid-19 pandemic.
Background. Face-to-face visits of hospitalized patients in intensive care units reduce separation anxiety and stress caused by hospitalization, as well as increase the feeling of comfort and safety in patients. In addition, it is the key to patient/family-centered care. However, the Covid-19 pandemic and its related restrictions ruled out the possibility of using the family's potential and providing patient/family-centered care. Virtual visiting has been proposed as a solution to remove the family's distance from the patient.
Method. This review was conducted by searching out databases, Web of Science, Scopus, PubMed, Magiran, SID and Cochrane with the keywords, Covid-19, Video calls, Family-patient center care, Intensive care unit, and Virtual visiting without time limitation. The inclusion criteria were the publication of the article in Persian or English language and the availability of the full text of the articles. In total, 45 articles were found, most of which focused on virtual appointments and virtual patient visits by physicians. After removing irrelevant papers, and the cases without full text, 29 articles were evaluated in terms of quality. Finally, 10 articles were evaluated in terms of subject, and the purpose related to the present study.
Findings. During Covid-91 pandemic, virtual visits were done in intensive care units in most medical centers using cell phones and tablets through social networks facilities. In all cases, families and health care providers were satisfied with this communication method, but they considered it was not a suitable substitute for face-to-face meetings. They believed that this method combined with face-to-face meetings would be more effective. Lack of regular and systematic planning, ambiguities in the duties of health care providers in the field of holding virtual visiting, lack of access to the internet at a suitable speed, and the complexity of working with smartphones for some families, were barriers of this method.
Conclusion. Virtual visiting provides a form of presence for families who are far away from their patients. Via this method, not only one but also all the family members can visit the patient. Although this method did not affect the stress and anxiety of the family and patients, but it was able to create a positive experience for them during hospitalization in intensive care units. Moreover, by involving the family in treatment process and informing them opens the ways to reach the patient/family-centered care in intensive care units.

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.

Mohammad Montaseri, Fatemeh Bahramnezhad,
Volume 12, Issue 1 (3-2023)
Abstract

Aim. The present study was conducted with the aim of reviewing the role of serum albumin in heart failure.
Background. Heart failure is a complex clinical syndrome that affects a large population worldwide yearly, and its mortality is even higher than that of many cancers. Although the identification of traditional risk factors has helped in primary prevention, the death rate due to this disease is still increasing. Identifying potential and modifiable risk factors that are not known yet seems necessary in this situation. Serum albumin has been known for many years as a strong prognostic biomarker in many pathological conditions. In recent years, studies have been conducted regarding the role of serum albumin in the prediction, prognosis and treatment of heart failure symptoms.
Method. This narrative study was conducted in 2023. For this purpose, the data bases, PubMed, Scopus, Web of Sciences, SID, MagIran were searched out with the keywords albumin, heart failure, diastolic failure, systolic failure, and a total of 30 articles were included in the study.
Findings. Hypoalbuminemia is a common finding in patients with heart failure, and among its main causes in heart failure are malnutrition, inflammation, lack of intestinal function, lack of kidney function, and liver disease. According to clinical and experimental evidence, hypoalbuminemia is related to fluid retention and exacerbation of pulmonary edema in these patients. Also, hypoalbuminemia can independently predict the onset of a new heart failure and can be measured as a prognostic factor of heart failure outcomes. However, there is still no evidence that directly shows the benefit of albumin injection in patients with heart failure.
Conclusion. Serum albumin can be measured as a modifiable risk factor and a prognostic factor in heart failure, but it is necessary to limit its use to cases where its effectiveness has been confirmed.

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.
 

Somaye Tajaldini, Fatihe Kermansaravi,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. The present study was conducted with the aim of reviewing the effect of telenursing in the care of patients with heart failure.
Background. Heart failure is one of the most common cardiovascular diseases, which is presented as a progressive and debilitating disorder. The prevalence of this disease is increasing due to the increasing age of the population, recent advances in the treatment of myocardial infarction, congenital diseases and the decline in mortality. In Iran, approximately one percent of all people over 40 years old have heart failure. The prevalence of this disease doubles with every decade of life and reaches about 10 percent in people over 70 years old. Studies have shown that specialized disease management programs for chronic heart failure (CHF) improve survival and quality of life and reduce health care utilization. Telenursing is one of the existing models.
Method. The present study is a narrative review. The researchers searched out the databases and search engines PubMed, Scopus, Web of Science, SID, Magiran, and Google Scholar using the keywords, care, chronic heart failure, nurse, telenursing and their Persian equivalent. After checking out the title and abstract of the articles found using the Joanna Briggs Institute (JBI) tool, the researchers reviewed 10 articles in this study.
Findings. Telenursing reduces hospitalization due to heart failure, reduces mortality and improves quality of life in patients with heart failure and improves education and follow-up after discharge. It also improves disease outcomes and reduces health costs.
Conclusion. The importance of paying attention to telenursing is recommended to policy makers and decision makers in the health system. 

Samaneh Nik-Chehreh, Mona Alinejad Naeini,
Volume 12, Issue 1 (3-2023)
Abstract

Abstract
Aim. The purpose of this review article is to introduce the phenomenon of patent ductus arteriosus (PDA) to health care providers of the neonatal intensive care unit, particularly nurses working in the neonatal intensive care unit.
Background. The patent ductus arteriosus is among the developmental diseases of the heart. The ductus arteriosus is the pathway that connects the left pulmonary artery to the descending aorta during fetal life. This duct closes in neonates within a few minutes to a few days after birth. Familiarity with this phenomenon may help health care providers in taking care of babies experiencing this condition. The transition from intrauterine to extrauterine life requires coordinated and complex biochemical, physiological, and anatomical changes that takes an extended period of time in premature infants and those with congenital conditions. Rapid and timely assessment and intervention by the health care team can help at this vital stage of life.
Method. This literature review was conducted through a systematic and targeted search of articles and texts published from 2008 to 2024 in PubMed/, Web of Science, Google Scholar, and Scopus using the keywords Patent ductus arteriosus, Infant, Nursing care, Treatment, and their Persian equivalents.
Findings. Twelve articles and one book were found and the findings were organized as definition and pathophysiology of patent ductus arteriosus, diagnoses. treatment options, and nursing care.
Conclusion. The transition of the fetus from the womb to extrauterine life is one of the dynamic and vital adaptations in the life of neonates, especially premature neonates. With comprehensive monitoring and skillful clinical assessment, patent ductus arteriosus in neonates can be better managed.

 

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.

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فصلنامه پرستاری قلب و عروق Iranian Journal of Cardiovascular Nursing
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