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.

Abstract

Aim. The aim of this study was to investigate the sexual satisfaction in patients with acute coronary syndrome.

Background. Sexual relationship is a multidimensional phenomenon which is affected by many psychological, individual and social factors. Satisfaction of sexual relationship leads to the strength of the family.

Method. In this descriptive-analytical cross-sectional study, 254 patients with acute coronary syndrome admitted to the coronary angiography ward in Shahid Beheshti hospital in Kashan, Iran, were recruited by convenience sampling in 2014. Data collection was done using the demographic and clinical data questionnaire and Larson's sexual satisfaction questionnaire. Data were analyzed in SPSS version 13 using descriptive and inferential statistics.

Findings. The mean score of sexual satisfaction was 101.7±15.3. The mean score of sexual satisfaction for men and women were 104.53±9.8, and 98.94±18.9, respectively (P=0.04). The results of linear regression showed that the relationship between sexual satisfaction and gender by taking other confounding variables was statistically significant (P=0.026). A history of diabetes (p=0.048), smoking (p=0.001) and hypertension (p=0.001) were affecting this relationship.

Conclusion. The level of sexual satisfaction in patients with acute coronary syndrome was high. The satisfaction in men were more than women. Also, a history of diabetes, hypertension and smoking in patients with acute coronary syndrome affected sexual satisfaction. Nurses should consider sexual needs of female patients with acute coronary syndrome, and also, that of acute coronary syndrome patient with a history of diabetes, hypertension and smoking.

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.

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.

Abstract

Aim. The aim of this study was to examine the effect of music therapy on ventilation criteria in mechanically ventilated patients in the intensive care unit.

Background. Complications made by mechanical ventilation are so much and considerable. Improvement of ventilation criteria is one of the factors that facilitatesweaning from mechanical ventilation.

Method. This randomized controlled trial was conducted in intensive care units of a teaching hospital affiliated to Iran University of Medical Sciences, Tehran, Iran. Seventy patients were recruited based on inclusion criteria and randomly allocated to experimental (n=35) and control (n=35) groups. For experimental group, relaxing music therapy was played with headphone for 30 minutes, once in the morning and once in the afternoon for one day. For control group, headphone was used without music for 30 minutes, once in the morning and once in the afternoon for one day. In both groups, ventilation criteria of respiratory rate, peak airway pressure and arterial saturation of oxygen (SaO2) were recorded in four intervals. Data analysis was performed in SPSS version 18 using statistical test.

Findings. Comparing of trends of ventilation criteria in experimental group showed that music therapy significantly reduced the mean respiratory rate (p= 0.0001), while in the control group, the mean respiratory rate slightly increased with time. In experimental group, the mean airway pressure reduced significantly within 30 minutes (17.30±3.65) compared with the time zero (19.68±3.64) (p=0.001). In the control group, the mean airway pressure increased slightly. The amount of spo2 did not differ significantly between experimental and control group (P=0.051).

Conclusion. Implementing music therapy in mechanically ventilated patients admitted to intensive care unit can reduce respiratory rate and maximum airway pressure. These could reduce the work of breathing and facilitate weaning the patient from ventilators.

Abstract

Aim. This study was conducted to examine the effect of combined inhalation of lavender oil, chamomile and Neroli oil on vital signs of patients with acute coronary syndrome.

Background. Increase in vital signs in patients with acute coronary syndrome worsens the disease and increases anxiety. The use of complementary medicine for better patient outcomes has been usually considered by the nurses due to the low complications and relatively low costs.

Method. This was a single-blinded, randomized clinical trial that carried out at the Emam Sajad Hospital in Shahryar, Tehran, Iran in 2016.  After obtaining the approval from the Ethics Committee of Iran University of Medical Sciences, 75 patients aged 20 to 80 years who signed the informed consent were recruited and randomly allocated into three groups (control, placebo, and intervention groups) using block randomization design (25 subjects in each group). In the intervention group, patients were asked to strew 2 drops of the aroma on an eye pad, keep their hands at the distance of 5 cm from their nose and take deep breath 10 times. After this, the pad was placed beside the pillow of the patient until the next morning. In the placebo group, this process was carried out using distilled water and the control group received routine care. The patients’ vital signs were measured before intervention, one hour after and every four hours after intervention until the next morning. Data were analyzed in SPSS, version 22, using chi-square test, t-test and ANOVA.

Findings. Before intervention, there was no statistically significant difference between three groups in terms of demographic characteristics as well as pulse rate, respiratory rate, systolic and diastolic blood pressure. The results showed that the combination of three aromas decreased pulse rate, respiration rate, systolic and diastolic blood pressure in one, four, eight and twelve hours after the intervention in the aromatherapy group compared to the time before the intervention.

Conclusion. The use of aroma as a complementary method in patients with acute coronary syndrome could decrease their pulse rate, respiratory rate, systolic and diastolic blood pressure. Due to the low risk and suitable accessibility to these aromas, the results can be used by nurses in the critical care unit and patient caregivers to improve patients' vital signs.

Abstract

Aim. This study was designed to determine complications experienced by family members of patient admitted to intensive care units and to identify related factors.

Background. Family is the most fundamental social community and has a basic role in human health. An acute illness of a family member and admission in critical care unit is considered as a stressful event resulting in some problems and undesirable outcomes for other family members.

Method. This review study was done in a systematized manner and based on library literatures. To do this, the articles published on family of critical patients during 2004-2016, searched out in different Farsi and English databases using keywords of "patient's family", "critically ill patient", "and family need". After screening articles according to inclusion criteria, 20 related articles were reviewed and analyzed.

Findings. Admission of  patients in critical care unit cause some negative reactions and complications in their family in the form of physical and psychosocial disorders. These undesirable outcomes are related to different reasons usually related to patient’s caring method and the manner of interaction with family members.

Conclusion. In general, following admission of one of family member in critical care unit, the family encounters a crisis, loses its functions and experiences some problems. Based on this, nurses, as the main pillar of care delivery system, should be responsible about patients’ family, pay attention to their needs and support the family though developing a family-center care plan. 

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. 

Abstract

Aim. The aim of this study was to compare quality of life (QoL) before and after angioplasty in people with coronary artery disease.

Background. The quality of life among people with CAD who undergo angioplasty treatment is of great interest because of the increasing number of patients receiving this treatment modality.

Method. In this descriptive analytical study, 473 patients with CAD admitted to all teaching hospitals of medical sciences universities located in Tehran were recruited through stratified random sampling over the years 2015-16.Quality of life in patients was measured before angioplasty, and one month and three months after angioplasty using SF-36 questionnaire. Reliability of this questionnaire has been reported in previous studies as 0.77-0.90 (Cronbach's alpha coefficient). Data were analyzed by Wilcoxon, Mann-Whitney and Kruskal-Wallis tests in SPSS version 23.

Findings. The results showed that angioplasty has increased the mean score of quality of life in total and also, in all dimensions, one and three months after surgery (P≤0.0001). The relationship of quality of life  with all demographic variables (age, marital status, occupation, education level, place of residence, conditions of residence and type of insurance) was statistically significant except for gender.

Conclusion. The angioplasty is well able to improve the quality of life in different dimensions in the short term.Angioplasty can be recommended as a procedure with strong and positive effect on the health conditions and quality of life in people with CAD.

Abstract

Aim. The present study aimed to examine the suicide ideation and intensity and dimensions of pain in people with cardiovascular disease compared with healthy people.

Background. A few researches have done in relation to the suicide ideation and the amount of pain and dimensions of pain.

Method. The research design was descriptive-comparative. Sample size consisted of 182 people including people with cardiovascular disease (n=91) and healthy people (n=91). The participants were recruited by convenience sampling from Emam Reza Clinic in Shiraz, Iran within a three-month period. Participants completed demographic form, and pain and suicide ideation questionnaires. Data were analyzed by analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) in SPSS version 21.

Findings. People with cardiovascular disease reported more suicide ideation and experienced more pain than healthy people. Moreover, people with cardiovascular disease had higher scores in all three dimensions of pain (sensational-physical, emotional-affective, and cognitive). The result of ANCOVA showed that after controlling pain variable, statistical significant difference between groups’ suicide ideation was removed .

Conclusion. It can be concluded that people with cardiovascular disease suffer from suicide ideation and emotional and cognitive pain along with physical pain. Pain also plays an important role in the incidence of suicide ideation in people with cardiovascular disease. 

Abstract

Aim. The aim of this study was to examine the effect of Mindfulness Based Stress Reduction (MBSR) on physical functioning and Health Related Quality Of Life in people with Coronary Artery Disease (CAD).

Background. According to the studies, CAD can affects physical functioning and HRQOL. Developing and examining psychological therapeutic models for improving quality of life and physical functioning would be appropriate.

Method. In this randomized clinical trial study with control group, 30 people with CAD were selected from coronary care unit of Abbasi Hospital of Mian-E-doab city, Iran, by convenience sampling and assigned randomly to experimental and control group. Data were collected by Seattle Angina Questionnaire (SAQ) for measuring for assessing health related quality of life and SF-36 for measuring physical functioning. The experimental group received mindfulness-based stress reduction program in eight 2.5 hours sessions, weekly. The control group did not receive any intervention.

Findings. The results showed that after controlling the pre-test effect, mindfulness-based stress reduction had a statistically significant effect on physical functioning and health related quality of life and their dimensions.

Conclusion. It can be concluded that mindfulness-based stress reduction influences physical functioning and health related quality of life by modulating biological and psychological processes.

Abstract

Aim. The aim of this study was to examine the effect of incentive spirometry and deep breathing exercises on arterial blood gas parameters after coronary artery bypass graft (CABG) surgery.

Background. After CABG, pulmonary complications and oxygenation disorders are common and play an important role in post-operative mortality and morbidity. The different methods are being used for improvement of pulmonary function and oxygenation after CABG.

Method. In this clinical trial study, 75 patients who were candidate for CABG surgery were recruited and randomly allocated to two intervention groups (incentive spirometry group and deep breathing exercise group) and control group. The groups were compared in terms of arterial blood gas parameters (PaO2, PaCO2 and SaO2) before surgery, and on the first day, the second day, and the third day after surgery.

Findings. The study findings showed that in the third postoperative day, there was a statistically significant difference between intervention groups and control group in terms of the mean of arterial blood gas parameters (PaO2, PaCO2 and SaO2). 

Conclusion. Incentive spirometry and deep breathing exercise are both significantly effective on improvement of arterial blood gas parameters (PaO2, PaCO2 and SaO2).

Abstract

Aim. This study investigated electrocardiogram changes among coal-Mine workers in Kerman, Iran.

Background. Chronic lung diseases such as pneumoconiosis, which cause air flow limitation are common among coal miners. Pneumoconiosis may results in heart disease and changes in the electrocardiogram. Due to the impact of pulmonary function on cardiovascular status, this index may show the risk of cardiovascular diseases in coal miners.

Method. This retrospective cohort study was conducted among 90 coal-mine workers in kerman as case group and 74 workers in the same mines who were not in contact with coal as controls between 2009-2013. The groups were matched in terms of age and work history. The inclusion criteria included age range of 30-45 years and work experience of at least 15 years. Individuals with a history of smoking, diabetes, obesity with a body mass index over 24, cardiac medications that caused ECG disorders and a history of systolic blood pressure above 120 mmHg were excluded from the study.

Findings. The mean age of the workers was between 32 and 46 with an average of 34.61 years. There was no statistically significant difference between groups in terms of age, weight and work history. Comparing electrocardiogram changes between the groups showed a statistically significant difference in the mean intervals of PR, QRS and QT in the leads D I, D II, and D III, with p≤0.0001, p≤0.01, and p≤0.001, respectively. ST segment interval was not significantly different between the groups.

Conclusion. Long term exposure to the coal may create electrocardiogram changes.