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Aim. The aim of this study was to evaluate the effect of early mobility on respiratory parameters in patients after open heart surgery. Background. Post-operative phase of open heart surgery is the most critical period during which many serious and fatal complication can occur. Early mobility can prevent such complications. The role of the critical care nurse is crucial in this regard. Method. In a randomized clinical trial, 104 patients who were candidate for open heart surgery were randomly assigned to experimental (n=52) and control (n=52) group. Patients in control group received hospital routine treatments. Patients in experimental group were mobilized from the bed in the first, second and third day after surgery. Early mobility included change position, siting on the bed, legs dangling off the bed, sitting in the chair next to the bed, and walking). The effect of early mobilization on respiratory indices was examined. Data were analyzed in SPSS version 18 using independent t-test, Chi-square and one way ANOVA statistical testes. Findings. There was no statistically significant difference between groups regarding demographic variables and underlying disease. Better lung function and arterial blood gases suitable changes were seen in the experimental group. Inspiratory capacity and arterial oxygen saturation was greater in the experimental than control group. Conclusion. Early mobility after open heart surgery is a safe and effective intervention and can have a positive effect on the patient's respiratory indices reducing pulmonary complications following surgery.

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Aim. The aim of this review was to introduce cardiac cachexia for health care team, especially nurses. Acquaintance of health care providers with cardiac cachexia may lead them to pay more attention to this phenomenon when taking care of heart failure patients with cardiac cachexia. Background. Heart failure is a systemic condition starting with heart dysfunction followed by dysfunction of most body organs including cardiovascular, musculoskeletal, renal, neuroendocrine, immune, haemostatic, and inflammatory systems. Heart failure is already considered as a multisystem disease which can lead to such morbidities as anemia, insulin resistance, autonomic nervous system imbalance, and cardiac cachexia. Despite the importance of cachexia phenomenon in people with heart failure, it seems that it is not sufficiently considered by health care providers in the treatment and care program. Method. In this paper, a review was conducted on the studies published between 1999-2016 about cardiac cachexia. The studies were searched out through scientific databases, including PubMed and Science Direct by the keywords heart failure and cachexia. The search resulted in 493 papers out of which 41 paper were considered in this review. Findings. In the last two decades, many attempts have been made to determine a unified definition of the cachexia. An anabolic/ catabolic imbalance with the dominance of catabolism which is the result of a combination of immunologic, metabolic, and neuroendocrine processes has been considered as pathophysiology of cardiac cachexia. In the early period after development of chronic heart failure, most of these processes are activated to protect heart and circulatory system from damage and also, to compensate for decreased cardiac muscle performance. Mechanisms of cachexia development are multiple, and it is necessary for treatment to consider several mechanisms simultaneously. Therapeutic management is based on prevention, exercise, nutrition, and drugs. Conclusion. Cardiac cachexia as a complication of chronic heart failure has adverse effects on patients’ quality of life and outcomes. The success of strategies for prevention or treatment of cardiac cachexia greatly depends on patients adherence to therapeutic regimen; multidimensional nature of strategies makes it necessary to be implemented in a comprehensive and right way.

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Abstract

Aim.The aim of this study was to compare the effect of education through lecture and multimedia methods on knowledge, attitude, and performance of cardiac care nurses about temporary pacemaker care.

Background.Cardiac dysrhythmias are among the most common cardiovascular disorders. Temporary pacemaker insertion is a treatment or prevention method for cardiac dysrhythmia. Nurses are the main group to provide the care for patients with temporary pacemaker, so it is necessary to educate them in an effective and efficient way.

Method.This was an experimental study conducted in 2015 on 52 cardiac care nurses working in ShaheedRajaei cardiovascular center. All 52 nurses were randomly divided in 2 groups of education through lecture and multimedia. The level of nurses' knowledge, attitude and performance was evaluated before and three weeks after education and the effect of education was examined using Mann-Whitney and Wilcoxon Signed Ranks Test through SPSS version 22.

Findings.Before intervention, the median and interquartile range of knowledge levels for lecture and mul-timedia groups were 12.5 (10-14) and 11 (9-12), respectively, and after that, they increased to 17 (15- 19) and 17 (13- 19). The median and interquartile range of performance levels for lecture and multimedia groups changed from 29 (26- 30) and 30 (26- 31) to 34 (32- 35) and 34 (32- 35), respectively. The knowledge and performance levels increased in both methods. But there was no statistically significant difference between these two methods. Before intervention, the median and interquartile range of attitude levels for lecture and multimedia groups were 62.5 (60-64) and 64 (63-66) and after that, they changed to 64 (60-64) and 63 (61-64), showing that intervention has no effect on attitude level in any of these two groups.

Conclusion.There is no difference between the effectiveness of education through two methods of lecture and multimedia software on cardiac care nurses' knowledge, attitude and performance. In the other words, multimedia software method is as effective as lecture method. Education using multimedia software can be considered as a proper method for increasing demand in staff education. Proper infrastructure and optimal training programs are prerequisites to effectiveness of education through multimedia software method.

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Abstract

Aim. The purpose of the present study was to examine the effect of supportive educational intervention on quality of sleep before coronary artery bypass grafting surgery.

Background. Patients who are waiting for surgery, experience high levels of stress and anxiety due to invasive nature of the procedure. This experience may influence their sleep quality. Disturbed sleep could lead to worsening the disease condition and reduces the process of recovery. Using non-pharmacological methods such as Benson muscle relaxation, deep breathing and guided imagery could be safe and useful for solving patients’ sleep problems before surgery.

Method. The present study was a quasi-experimental clinical trial in which 160 patients undergoing coronary artery bypass grafting surgery who hospitalized in cardiac surgery wards and cardiac intensive care units of selected hospitals of Tehran University of Medical Science were recruited and divided into two experimental (n=80) and control (n=80) group. Demographic data questionnaire was given to the patients at the first day of hospital admission. The control group received routine care. The intervention group received routine care and supportive educational intervention for at least two days between 4 and 6 p.m. All of the patients filled Groningen sleep quality scale in the day of surgery. Data analyzed by SPSS version 16.

Findings. Before surgery, the mean score of sleep quality was 4.6±5.50 in intervention group and 10.76±1.27 in control group.  There was a statistically significant difference between the experimental and control group in terms of sleep quality as the experimental group reported higher quality sleep than control group (P<0.0001).

Conclusion. Implementation of non-pharmacological methods such as relaxation, deep breathing, and guided imagery could be a good alternative method for hypnotic and sedative drugs. This could be one of the nursing interventions before coronary artery bypass grafting surgery as a safe, available and useful method.

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Abstract

Aim. This study aimed to examine the effect of education by video self-assessment on nurses’ knowledge and performance about cardiopulmonary resuscitation (CPR).

Background.Cardiopulmonary arrest is one of the main medical emergencies and one of the major causes of death around the world. Cardiopulmonary resuscitation is the critical components of basic life support in response tocardiopulmonary arrest. The success ofcardiopulmonary resuscitationrequiresproficiencyandperformance of resuscitation group.

Method. This was a clinical trial study conducted on 80 nurses that were randomly divided into experimental and control group. Participants in control group received traditional training and experimental group experienced video self-assessment after traditional training. Knowledge on CPR was evaluated with a valid questionnaire including multiple choice questions. Psycho-motor skills were measured through a visual checklist observing CPR performance of the participants on a manikin. Outcome variables were measured three times (before, immediately after, and two months after training). Data were analyzed by the SPSS through repeated measures analysis.

Findings. Comparing the mean score of knowledge between the groups at before, immediately after, and 2 months after training did not show any statistical significant difference. Immediately, and two months after intervention, the mean score of performance of the experimental group was significantly higher than that of control group.

Conclusion.Education by Video self-assessment is an effective method to improve nurses’ performance in CPR.

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Abstract

Aim.The aim of the study was to determine the relationship between prodromal symptoms and referring time in patients with myocardial infarction in cardiac care unit of Rafsanjan Imam Ali-ibnAbi-Talib hospital in 2012.

Background.There is little information about how people respond to prodromal symptoms of myocardial infarction and how fast they refer to medical centers.

Method.In a cross-sectional study, 175 patients with acute myocardial infarction were recruited. For data collection, lasting about seven months, a questionnaire consisting of demographic data, risk factors for heart disease, prodromal symptoms, referring time and causesof delay was used. Questionnaires were completed by the researcher with bedside interview with patient and using medical records. Data were analyzed in SPSS version 18 using descriptive statistics (mean, standard deviation, frequency distribution and percentage) and inferential statistics (Chi-square test and Pearson coefficient).

Findings.The majority of patients were male (76.6%) and middle-aged (53.1). Of 175 patients, 132 (75.4%) had experienced warning sign, two weeks before the cardiac event and 43 (24.6%) had experienced no symptoms. Also, 51  patients (38.6%) had referred the physician office, clinic or hospital after experiencing warning signs. The time duration of patients arrival to hospital ranged from 15 minutes to 1500 minutes. There was a statistically significant correlations between prodromal symptoms and referring time in patients with myocardial infarction (p=0.007). Findings showed that the average total referring time was 206.94 minutes.

Conclusion. Recognizing prodromal symptoms leads to earlier seeking treatment in patients with myocardial infarction. Education for increasing public awareness of warning symptoms, especially for those with family history and risk of cardiovascular disease seems to be an appropriate strategy.

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Abstract

Aim. The purpose of this study was to determine factors influencing the time interval from the onset of clinical symptoms to thrombolytic infusion in patients with acute myocardial infarction

Background.Acute myocardial infarction is one of the most common causes of death and disability all over the world including Iran. The major cause of myocardial infarction, is the clot of blood in the coronary atherosclerotic plaques. Immediate administration of thrombolytic therapy in these patients can be life-saving.

Method. This study was a cross-sectional descriptive-analytical study in which 98 patients with acute myocardial infarction hospitalized in selected Rasht therapeutic centers were recruited by convenience sampling in 2014.Data collection instrument included demographic information form and researcher-made questionnaire to obtain patients' clinical, situational and cognitive factors. Data were collected through patients medical records and interview. Data were analyzed in SPSS version 21 using non-parametric Mann-Whitney and Kruskal Wallis tests and P<0.05 was considered as significant.

Findings. The mean time interval from the onset of symptoms to the beginning of thrombolytic infusion was 247.2±182.4 minutes.In this study, the most pre-hospital delay was related to making decision for care seeking and in-hospital delay time was the least one. The patients had delay in referring to the hospital mainly due to the following: negative history of previous heart disease) p=0.001), lack of awareness about the signs and symptoms of the disease )p<0.0001), female gender) p=0.026 ,(an underlying diabetes )p= 0.001),low levels of education (p=0.003), low income )p=0.044),mild pain )p=0.001), and self-medication )p=0.003).The main cause for delay was related to the lack of awareness of the symptoms and ignorance of their importance.

Conclusion. The time interval from the onset of symptoms to thrombolytic infusion in patients with acute myocardial infarction was not satisfactory. It is necessary to provide required training programs for increasing the individuals’ awareness about the symptoms of the disease and the importance of treatment with thrombolytic drugs, as soon as possible, in order to minimize the time delay, thereby, increasing the efficiency of treatment, and ultimately reducing the mortality and disability of patients.

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Abstract

Aim.The aim of this literature review was to study medical staff knowledge about cardiopulmonary resuscitation for pregnant women.

Background.Cardiopulmonary resuscitation (CPR) in pregnancy is a rare event. Although rare, CPR during pregnancy is very important, because saves the life of the mother and fetus. Knowledge of medical staff and their formal training on CPR in pregnancy are such factors affecting the maternal and fetal outcomes. Knowing the state of medical staff knowledge in this area will help recognize the existing gaps and plan for improvement.

Method.In this narrative review, databases such as Medline, Science direct, Ovid, Scopus, SID, Magiran and Barakat Knowledge Network System was used to data collection. Articles published between 2000-2016, were searched out by the keywords "cardiopulmonary resuscitation",‌"pregnancy", "knowledge","medical Staff", both inPersian and English. Inclusion criteria was content similarity to subject under study. 

Findings. Out of 20 retrieved papers, 4 cross- sectional analytical articles published between 2008-2012 was selected and reviewed for describing the state of medical staff knowledge on CPR in pregnancy. The knowledge of medical staff was in poor level in different areas such as proper pregnant patient positioning during CPR, sequence of bag- mask ventilation and intubation, defibrillation (application during pregnancy, paddle placement location, energy and considerations), the use of drugs and therapeutic doses and cesarean section in within 4-5 minutes following CPR failure.  

Conclusion.The knowledge of medical staff about CPR in pregnancy is poor. Establishing continuous educational course to improve their knowledge is recommended. 

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Abstract

Aim. The aim of this paper is to review studies related to sodium restriction and adherence to this restriction in patients with heart failure.

Background. In the last decade, there has been a dramatic increase in the prevalence and incidence of chronic heart failure. Non-pharmacological and non-surgical therapies in the management of chronic heart failure play an important role, and low sodium intake, by reducing fluid retention, improves symptoms and prevents worsening of the disease, but adherence to nutritional regimes is often less than adherence to medications.

Method. We reviewed studies published over the recent 15 years regarding sodium restriction in patients with heart failure. These were searched out through scientific databases, including PubMed and Science Direct by the keywords adherence, chronic  heart failure, low-sodium diet, sodium restriction, low salt diet and their Persian equivalents.

Findings. In the reviewed studies, sodium intake assay and patient's adherence to sodium restriction were different. Although sodium restriction is known as the basic management of heart failure, butthere are not consensus about its usefulness. It was also found that there is no specific guidelines for sodium restriction in heart failure, and that a small percentage of patients follow sodium restriction. Few studies have been conducted regarding related factors of adherence to the sodium restriction diet in patients with heart failure. Also, non-pharmacological methods including education and counseling have not been successful in improving patients’ adherence.

Conclusion. Further research with higher methodological quality, larger sample size and the use of appropriate and accurate approach to measure sodium intake is needed. To achieve a sodium restriction diet is possible, but difficult. Although, there is no consensus on the exact amount of the reduction of daily sodium intake, but seems that reduction in sodium intake can improve symptoms and quality of life in patients with heart failure. Theory-based and family-based interventions may be able to help improving patients’ adherence to sodium restriction diet, although more studies are essential to be conducted.

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Aim.The aim of this study was to determine nurses’ knowledge, attitude, and performance in cardiopulmonary resuscitation (CPR) based on PRECEDE model.

Background. Despite development of CPR team in Iran’s hospitals, performance in the field of CPR is not satisfactory.

Method. In this cross-sectional descriptive analytical study, all staff nurses (n= 97) working at ateaching hospital (9 Day) in Torbat-e-Heiydariyeh, Iran, were studied.The data collection tools included a reliable and valid researcher-made questionnaire to collect demographic data and a questionnaire which developed based on PRECEDE model.Data were analyzed in SPSS version 20 using ANOVA, linear regression and Pearson correlation coefficient.

Findings. The mean age of the nurses was 29.45±7.45 years.The average score for PRECEDE model constructs were 79.17±18.68 (knowledge), 95.48±6.64 (attitude), 62.6±19.52 (enabling factors), 67.61±20.12 (reinforcing factors), and 72.37± 9.71 (performance).Also enabling factors were the most important predictor of nurses’ performance (B=0.773, p<0/0001).A statistically significant relationship was observed of nurses’ performance with gender (p=0.007) and experience of CPR (p=0.027). There was a positive significant correlation of enabling factors with reinforcing factors (p=0.007, r=0.274) and behavior (p=0.000, r=0.773).

Conclusions. Constructs of knowledge, attitude, and performance were in desirable level and constructs of reinforcing and enabling factors were in moderate level. It is recommended to implement interventions and programs while considering enabling and reinforcing factors for promoting the performance of nurses in CPR.

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Abstract

Aim.The present study aimed to examine the relationship of perfectionism with procrastination and coping styles in people with coronary heart diseases (CHD), compared with healthy controls.   

Background. Psychological factors may increase the risk of CHD by influencing physiological risk factors. Although psychological factors play an important role in development of CHD, more research in this area is necessary.

Method. In this descriptive correlational study, 218 male people (107 people with CHD as case group, and 111 people without CHD as their controls) were selected by convenience sampling. Data were collected by Mann’s Decisional Procrastination Scale, Lay’s Behavioral Procrastination Scale, coping styles Scale by Endler and Parker and Tehran Multidimensional Perfectionism Scale. Pearson correlation coefficient and linear regression were used for data analysis.

Findings.According to the findings, other-oriented perfectionism was directly associated with behavioral and decisional procrastination in case group, while in the control group, other-oriented perfectionism was negatively associated with decisional procrastination, however, the association was not significant. The effect of other-oriented perfectionism on decisional procrastination was significant in both groups. In case group, other-oriented perfectionism had a significant effect on behavioral procrastination, however other-oriented perfectionism had a significant effect on problem solving style in control group.

Conclusion.Other-oriented perfectionism had positive, but not strong relationship with both aspects of procrastinations in case group. In regression models of different aspects of perfectionism on procrastination, only the effect of other-oriented perfectionism was significant. Although the regressions were significant, fitted models had low predictive power. Only the other-oriented perfectionism could somewhat predict behavioral and decisional procrastination.

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Aim. This study aimed to determine predictive power of obesity indices, cardiovascular fitness and physical activity in the development of cardiovascular disease (CVD) in male and female college students.

Background. Given the high mortality due to cardiovascular diseases from the young age caused by obesity and physical inactivity, the primary prevention, especially at an early age can be a solution to avoid the disease. Initial screening by simple, secure and affordable methods for prevention is essential.

Method. A total of 223 students (150 males, age 20.33±1.71 and 73 females, age 20.36±1.72) participated in this cross-sectional descriptive study. Data were obtained using a questionnaire, anthropometric measurements, and cardiovascular fitness (VO₂max). Independent t-tests was used to show difference between gender in terms of variables, ANOVA was used to determine the differences among groups of male and female separately, whose had the different number of risk factors, and Pearson and Spearman correlation coefficient were used to determine the correlation of obesity indices and VO₂max with metabolic risk factors, and the ROC curves was used to measure the power of predicting and the cut-off points of cardiovascular risk factors.

Findings.Statistically significant correlation was found between obesity indices and metabolic risk factors (other than blood glucose and systolic blood pressure in males). As the number of metabolic risk factors increased, elevation in obesity indices in females and the reduction of VO₂max in males were significant. All obesity indices were within normal range. Cut-off points calculated by the ROC were 21.11 for body mass index and 75.15, 0.44 and 75.50, 0.47 for waist circumference and the waist-to-height ratio, for males and females respectively.

Conclusion. The findings of this study showed that the obesity indices are more powerful than physical activity levels and VO₂max for predicting the possibility of cardiovascular disease among students.

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Abstract

 Aim. The aim of this paper is to review studies related to fatigue in patients with heart failure.

 Background. Fatigue is a subjective feeling and a multifactorial phenomenon in patients with heart failure. Fatigue is an important symptom of heart failure; however, lack of information exist regarding this phenomenon. Also, fatigue is considered as a challenge by health care providers and clinical guidelines have paid less attention to fatigue in these patients. 

 Method. This article reviewed studies published regarding fatigue in patients with heart failure. The studies were searched out through scientific databases, including PubMed and Science Direct by the keywords fatigue, predictors, related factors, heart failure and their Persian equivalents.

 Findings. The literature review revealed that the prevalence of fatigue in patients with heart failure is high and different findings have been reported regarding its severity in these patients. Fatigue and its increasing trend during the disease progress is related to unsatisfactory quality of life and clinical outcome. In various studies, multiple factors including the nature of the illness and psychological factors particularly depression have been reported as predictors of fatigue and its severity in patients with heart failure. Few studies were conducted with the aim of evaluating the effect of non-pharmacological intervention on management of fatigue in these patients.

 Conclusion. According to the high prevalence of fatigue in patients with heart failure, it is essential to consider timely interventions by health care providers, particularly nurses, for reducing it and improving patients’ well-being. Regarding the limitation of studies and importance of reducing fatigue, it is necessary to conduct further research to evaluate the effect of non-pharmacological interventions on symptom management (especially fatigue) in these patients.

 

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Abstract

Aim. This study aimed to determine the relationship of spiritual experiences with the life expectancy and death anxiety in patients undergoing coronary artery bypass grafting (CABG).

Background. The patients undergoing CABG experience a critical situation that requires taking into account such factors as life expectancy, spiritual experience, and death anxiety. During taking care of these patients, nurses must consider these experiences and their relationship.

Method. In this descriptive-analytic study, 150 patients undergoing coronary artery bypass surgery in hospitals located in Kerman city, Iran, were recruited within an 8 months period in 2015. Data were collected using a questionnaire including demographic data, Templer Death Anxiety Scale, Adult Hope Scale and the Scale of Daily Spiritual Experiences (DSES). Data were analyzed in SPSS version 20 using Pearson correlation test, Independent T-test, ANOVA and multiple linear regression.

Findings. There was a statistically significant negative correlation of daily spiritual experiences with death anxiety (p=0.004) and death anxiety with life expectancy (p≤0.0001). There was also a statistically significant positive correlation between spiritual experiences and life expectancy (p≤0.0001). Multiple linear regression analysis showed that age and life expectancy predicted 61 percent of changes related to spiritual experiences.

Conclusion. The findings suggest that paying attention to spiritual experiences of patients may increase life expectancy and reduce the death anxiety. It is suggested to include supporting, facilitating and attending to the spiritual needs of patients in nursing care plans for these patients.

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Abstract

Aim. This article reviews the effects of Hirudo Medicinalis in coagulopathies and cardiovascular diseases.

Background. Hirudo Medicinalis is one of the conventional treatment methods in folk medicine in many countries of the world and is today paid more attention to. The use of this therapy is increasing considerably but no much effort has been done to explain about the effectiveness and mechanisms of action.

Method. In this review, databases and search engines such as PubMed, Google Scholar and SID were searched out for literature published between 1989 and 2016, using the English keywords "Hirudo medicinalis/Leech therapy, mechanism of action, cardiovascular disease, homeostasis, and anticoagulant, and their Persian equivalents, individually or in combination. In addition, Persian available books available were used.

Findings. Hirudo Medicinalis is used in the treatment of arterial hypertension, angina and myocardial infarction and has anticoagulant effects. The literature emphasizes on the role of nurses in the care of patients under this treatment.

Conclusion. According to studies, it seems that Hirudo Medicinalis can be used as a complementary medicine technique in the treatment and research of cardiovascular and coagulation disorders Normal 0 false false false EN-US X-NONE AR-SA      

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Abstract

Aim. The aim of this study was to review studies about advantages and disadvantages of transradial and transfemoral coronary angiography. Transradial coronary angiography procedure is newer than transfemoral approach and inadequate knowledge and experience in this area needs to be considered for minimizing possible complications. 

Background. An increasing trend of cardiovascular diseases is of great importance. Although any different methods have been suggested for diagnosing coronary artery diseases, but coronary angiography remains as the best diagnostic and therapeutic method. Transradial and transfemoral coronary angiography as two approaches for diagnosing coronary artery diaseses have their own advantages and disadvantages.

Method. In this review study, various databases such as Google Scholar, PubMed, AHA journal and Elsevier were searched out by Persian and English forms of the keywords “Transradial coronary angiography”, “Transfemoral coronary angiography”, “Nursing care in coronary angiography” and “complications of coronary angiography”.

Findings. The findings are presented as follows: Comparison of the advantages and disadvantages of both radial and femoral approach, nursing care in radial angiography procedures and comparing patients’ satisfaction of experiencing radial or femoral angiography.

Conclusion. If the preparation and care before, during and after coronary angiography is properly settled and there is trained staff and physicians, it is suggested to use transradial approach for coronary angiography because of its fewer side effects and greater convenience the patients have with.

     

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Abstract

Aim. The aim of this study was to examine the effect of early mobilization on hemodynamic parameters in patients undergoing coronary artery bypass graft (CABG) surgery.

Background. CABG is one of the most common surgeries that can increase quality of life and reduce mortality in most cases. It seems that early mobilization of patients from bed may reduce complications after surgery. The most important concern regarding early mobilization is the possible effect on hemodynamic parameters based on which this important intervention is neglected.

Method. In a clinical trial with 100 patients who were candidate for CABG. The patients were randomly assigned to experimental and control group. The experimental group were mobilized from bed in the first, second and third day after surgery. The control group received the hospital routine treatments and mobilization was done in the third day after the operation. The effect of early mobilization on hemodynamic parameters were compare between the groups. Other treatment programs were the same for both group. Data were analyzed in SPSS version 18 and using independent t-test, Chi-square and ANOVA statistical testes.

Findings. There was no statistically significant difference between groups regarding demographic variables and underlying diseases. In the experimental group, blood pressure was higher in the second and third days  compared with that control group. Chest tube drainage on the third day were 495±241 ml for experimental group and 556±285 ml for the control group, and no statistically significant difference was found between the groups in terms of chest tube drainage. None of the patients showed any complication during the mobilization.

Conclusion. The experimental group experienced a minimal increase in blood pressure, but it was not clinically significant. The results of this study indicate that early mobilization from bed in patients undergoing coronary artery bypass graft is a safe and applicable intervention, and don’t increase bleeding and acute hemodynamic changes.

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Abstract

Aim. This study aimed to review indications, benefits, limitations and procedure of continuous ST segment monitoring in critical care unites.

Background. Although the 12-lead electrocardiography is a standard and reliable tool to detecti ischemia in Acute Coronary Syndrome (ACS) patients, but it provides only a static snapshot. The American Heart Association (AHA) and American Association of Critical Care Nurses (AACCN) practice standards for ECG monitoring recommend continuous ischemia monitoring for all patients at risk of myocardial ischemia.

Method. This was a review study. International databases such as Proquest, CINAHL, PubMed, Scopus and one national database (SID) were searched out using the keywords; ST-segment Monitoring, Cardiac Monitoring and Acute Coronary Syndrome to find out materials published between years 2000 and 2015. About 189 citations were evaluated, out of which 15 citations were recruited in the final review.

Findings. Although continuous monitoring of ST segment has been introduced many years, but this technology is not widely used.Continuous monitoring of ST segment provides a frequent and dynamic assessment of changes associated with ischemia.Continuous ST segment monitoring as an effective method can be used to provide continuous and dynamic snapshot of ischemia, to evaluate response to reperfusion and anticoagulant therapy and also, can be used for prognostic or research purposes.  

Conclusion. Despite some limitations, the use of continuous ST segment monitoring is recommended for patients with ACS, besides routine assessment.