Abstract
Aim. This study was conducted with the aim of determining the effect of peer education on outcome in people with heart failure.
Background. Heart failure is a complex clinical syndrome that is considered as a public health problem due to its chronic, progressive and irreversible nature.
Method. In this review study, a comprehensive search of scientific databases and search engines such as Science Direct, Scopus, PubMed, Google Scholar, and Medline using the keywords heart failure and peer education in both Persian and English language was done to find literature published between 2000 and 2018.
Findings. Studies about the effect of peer education on outcomes of heart failure patients in the country showed that these trainings have examined three outcomes of self-care, quality of life and self-efficacy in people with heart failure, and that this method has had a positive effect on all three components.
Conclusion. Peer education improves self-care, self-efficacy, and quality of life in people with heart failure. It is recommended to use this training program as an effective, cost-effective method without the need for specialized equipment.

Abstract
Aim. This study was conducted to investigate palliative care in people with heart failure.
Background. Heart failure as a syndrome of cardiac dysfunction has a variety of pathophysiology. Progress in knowledge related to heart failure has led to improvement in survival, but the incidence and prevalence of the syndrome is incremental. Cure of the disease is rarely possible and as a chronic disease it can significantly affect the patient, family and health care system. Providing care for patients with heart failure is a complex phenomenon and as the disease progresses to the late stages, palliative care takes a larger part of the caring.
Method. In this review study, scientific databases and search engines such as SID, Scopus, PubMed, and Web of Science were searched for to find articles published from the beginning of 2000 to 2017. The keywords used for the search included heart failure, palliative care and their Persian equivalent. Papers in Persian and English that were available on the common theme of heart failure and palliative care were reviewed.
Findings. A total of 36 English and one Persian article were reviewed. The definitions of palliative care, views on palliative care, palliative care drugs, types of palliative care providers, palliative care models, palliative care delivery to family caregivers, and the future of palliative care were the topics covered in the reviewed articles.
Conclusion. Palliative care for people with heart failure should be considered in line with the treatment plan of these patients. Special attention should be payed to development of specialty palliative care and long-term planning for primary palliative care

Abstract
Aim. The aim of this review was to investigate the role of Catecholamines in the pathogenesis of Takotsubo cardiomyopathy and related nursing care.
Background. Takotsubo cardiomyopathy is an acute syndrome characterized by acute reversible systolic dysfunction of the apical and middle segments of the left ventricle in the absence of significant coronary artery occlusion. It is believed that emotional and physical stressors are the main drivers for the disease. Despite many years of efforts to better understand this disorder, current knowledge is limited, but several authors have agreed on the relationship between Catecholamines and the development of this syndrome.
Method. This study was carried out by searching the databases and search engines (PubMed, Google Scholar, and Web of Science) to find full text articles published between 2014-2018 using the keywords "Broken heart syndrome", "Apical ballooning syndrome", "Takotsubo cardiomyopathy", "Stress-induced cardiomyopathy", “Catecholamines”, “Nursing” and “Nursing care”. Of 392 articles, 21 were included in the study.
Findings. Among the various hypotheses, Catecholamine-induced microvascular dysfunction is currently the most accepted hypothesis. Stressful stimuli can increase the activity of the Hypothalamus-Pituitary- Adrenal axis and release Catecholamine. If Catecholamines are the leading cause of Takotsubo cardiomyopathy, it is quite possible that prescribing exogenous Catecholamines cause this condition.
Conclusion. Although many studies have attributed some of the Catecholamine toxicity to the pathophysiology of Takotsubo cardiomyopathy, due to the potential impact on current treatment strategies, further study is required. Due to cardiovascular side effects, the use of Catecholamines for therapeutic purposes requires more evidence. Regarding the similarity of the symptoms of this syndrome with myocardial ischemia, nursing care in this type of cardiomyopathy is very important.

Abstract
Aim. The purpose of this study was to determine the effect of early mobilization program on incidence of arrhythmias in patients after acute myocardial infarction in Imam Khomeini Hospital in Dehdasht, Iran.
Background. Acute myocardial infarction is one of the most common causes of disability and mortality in most countries. Rehabilitation and mobility management of these patients, immediately after admission to the cardiac care unit, can reduces complications and decreases their physical and cognitive function impairment.
Method. This was a clinical trial study, in which 60 patients with acute myocardial infarction, referred to Imam Khomeini Hospital in Dehdasht, Iran were selected by convenience sampling during the year 2019 and randomly assigned to experimental (n=30) and control (n=30) groups. In the experimental group, patients received an organized program in 8 stages, 18 hours after admission to the cardiac care unit, and in control group, the patients got out of bed 48 hours after admission based on the usual protocol. Patients were monitored before, during, and after getting out of bed for the number and type of arrhythmias. Data were analyzed by descriptive and inferential statistics in SPSS version 22.
Findings. There was a statistically significant difference between the experimental and control group in the number and type of arrhythmias, 48 hours and 51 hours after admission in the cardiac care unit. However, this difference was not statistically significant at 54 hours after admission to the cardiac care unit.
Conclusion. Early mobilization can reduce the number of arrhythmias in patients after myocardial infarction. Early mobilization can be included in the cardiac care unit rehabilitation program as a safe mathod. Therefore, it is recommended to use early mobilization program for patients with acute myocardial infarction in cardiac care unit on the first day of hospitalization.

Abstract
Aim. This study was conducted to examine the relationship of marital satisfaction and self-care behavior in people with chronic heart failure
Background. Chronic heart failure is one of the most important problems in public health and it would impose heavy costs on society and family. Self-care plays an important role in managing heart failure and can be influenced by social support. The patients receive the highest level of social support from their families.
Method. In this descriptive study, 251 patients were selected by convenience sampling method. The instruments were Enrich marital satisfaction questionnaire, and The European Heart Failure Self-care Behavior  (EHFSCB). Collected data were analyzed in SPSS version 16 using descriptive and inferential statistics.
Findings. The results showed that 58.8 percent of participants were male, with a mean age of 59.66 years. The mean score of marital satisfaction was 145.6±41.98. Most participants (46.9 percent) had partial marital satisfaction. The mean score of self-care was 34.5±12.24 and most participants (41.2 percent) reported good self-care. There was a statistically significant negative correlation between the marital satisfaction and self-care scores.
Conclusion. Due to the positive effect of self-care behaviors on marital satisfaction and because most people with chronic heart failure have partial marital satisfaction, it is recommended to study factors influencing these components. It is suggested to support and teach patients and their families in order to improve marital satisfaction and promote self-care behaviors in these patients.

Abstract
Aim. The present review study was conducted to investigate the effect of family-centered care education on outcomes of heart failure in Iranian patients.
Background. Heart failure is a complex clinical syndrome that poses a health problem due to its chronic, progressive, and irreversible nature.
Method. A comprehensive searching out scientific databases and search engines including Science Direct, Scopus, PubMed, Google Scholar, and Medline with the keywords heart failure and family-centered care education in both Persian and English language was done to find published studies between 2000 to 2020. Six articles were found based on inclusion criteria and reviewed to report their dominant findings.
Findings. Studies on the effect of family-centered care education on outcomes of heart failure in Iranian patients showed that this educational method has yield in effective results.
Conclusion. Family-centered care training improves and promotes self-care and quality of life in people with heart failure. Using this training program is recommended as an effective, cost-effective training method without the need for special equipment.

Abstract
Aim. This study aimed to examine the effects of preoperative preparation of patients and family caregivers on outcomes after coronary artery bypass graft surgery (CABG).
Background. Preoperative preparation can improve patients’ experience of surgery and hospitalization. However, there is limited data about how preoperative preparation affects postoperative outcomes following CABG.
Method. This non-randomized clinical trial was conducted on ninety pairs of patient/ caregiver in the time period from July to November 2018. The participants were purposively selected and non-randomly allocated to either control or experimental group. The intervention was performed one day after admission and the day before CABG in the form of an educational video, an intensive care unit tour, and an educational booklet. In both groups, on the third day after surgery, patients' delirium was assessed in the ICU and family caregivers were asked to complete a family satisfaction questionnaire. Patients and their family caregivers in both groups completed a hospital anxiety and depression questionnaire (HADS) on the first and seventh days after surgery and before discharge. Data were analyzed in SPSS version 16.0 using descriptive and inferential statistics. 
Findings. After intervention, the mean score of patients’ anxiety and depression in the intervention group was significantly less than the control group (P=0.03). After intervention, the mean score of anxiety and depression among family caregivers in the control and experimental groups were not significantly different (P=0.11). Family caregivers’ satisfaction of experimental group was significantly higher than the control group in both healthcare providers’ performance dimension (P=0.01) and comfort dimension (P=0.027). Moreover, the groups did not significantly differ from each other regarding delirium incidence (P=0.6) and length of stay in the intensive care unit (P=0.21).
Conclusion. Considering that the preparation of the patient and family caregiver on the day before CABG can reduce patients' anxiety and depression and increase the satisfaction of the family caregiver, it is recommended to use this intervention for patients and family caregivers before CABG.

Abstract
Aim. This review study aimed to investigate the role of thirst in the development of delirium in patients admitted to intensive care units.
Background. Delirium is a common clinical syndrome in patients admitted to intensive care units, affecting approximately one-third of these patients. Delirium is a multidimensional phenomenon. One of the most important and controversial factors in the occurrence of delirium is the phenomenon of thirst.
Method. This study was conducted by searching out Persian and English databases of Magiran, SID, Web of Science, Science Direct, PubMed, Scopus, without publication year consideration and using the keywords "thirst", "dehydration", "hyperosmolarity" and "delirium". Of 55 articles retrieved, 17 articles were reviewed by the research team among, and finally, after complying with the inclusion criteria and evaluating the quality of articles, 6 articles were included in the study.
Findings. The findings of the present study showed that tolerating the thirst for more than 24 hours is a risk factor for delirium. The role of fluid deficiency in the pathogenesis of delirium is not fully understood, but factors such as tissue hypoperfusion (especially in the brain and kidneys), increased concentrations of drugs or their metabolites in reduced intravascular volumes, and decreased renal function in excretion and/or drug metabolism are possible causes for development of delirium.
Conclusion. There is a lack of studies in this area and due to the importance of delirium and thirst in patients in the intensive care units or the elderly patients, more studies should be conducted in this area. All these factors calls for more attention and studies in this area.

Abstract
Aim. This review study explores cardiovascular changes in preterm neonates during the transition from intrauterine to extrauterine life, respective challenges, and nursing care during this period.
Background. The transition from intrauterine to extrauterine life requires well-regulated and complex biochemical, physiological, and anatomical changes to ensure the survival of the neonate. Compared with term neonate, transition for a preterm neonate occurs over a longer period of time. Careful assessment and timely intervention by health care providers is pivotal to help the preterm neonate adapt to extrauterine life.
Method. This review study was conducted through systematic and focused searching out for literature published between 2000 and 2020 in database/ search engines Google Scholar, Web of Science, PubMed, Scopus by the selected keywords Transition, Extrauterine life, Preterm neonate, Nursing care and their Persian equivalents.
Findings. Twenty six English articles and two books about neonate related to the topics of transition to neonatal extrauterine life, challenges and respective nursing care were found. Findings were organized into five thematic category: immature myocardium, blood circulation, patent ductus arteriosus (PDA), hypotension and hemodynamic instability.
Conclusion. Comprehensive hemodynamic monitoring and skillful clinical evaluation, and wise judgment are recommended for better management of complex transition phenomena in preterm neonates. Management protocols should be developed for transition period in preterm neonates.

Abstract
Aim. This review study was conducted to review the effects, challenges and strategies for providing spiritual care in people with heart disease.
Background. The management of people with heart disease is complex and the course of the disease is unpredictable. The needs of people with heart disease are varied. The available evidence confirms the high level of patients' spiritual needs and desire to receive spiritual care.
Method. In this study, scientific databases and search engines such as Google Scholar, SID, Scopus, PubMed and Web of Science were used to find papers published between 2000 and 2020. The keywords included spiritual care, cardiac disease, cardiac patient, heart disease, coronary artery disease and their Persian equivalents. The selected articles for review were those in Persian or English language and about spiritual care and people with heart disease that their full text were available.
Findings. A total of 27 articles were reviewed. The spiritual needs of people with heart disease, the effect of spiritual interventions in reducing the symptoms of these patients and the problems of achieving this goal and the way to solve them were reviewed.
Conclusion. Spiritual care in patients with heart disease improves quality of life, spiritual well-being, reduces anxiety and depression; therefore, it is necessary to include spiritual care in the usual care of people with heart disease.

Abstract
Aim. This study was conducted to examine the effect of mentalization-based therapy and emotion-regulated therapy based on the Gross process model on psychological well-being and quality of work-life of nurses in intensive care units.
Background. Improving nurses' well-being and satisfaction with their quality of work-life improves the nurse-patient relationship and hospitals' performance from an organizational point of view. It is necessary to provide psychological therapeutic interventions to this crucial group of health care providers.
Method. This study was an experimental  study (pre-test post-test with control group) in which 45 nurses working in intensive care units of selected Tehran hospitals, Iran, were selected by the convenience sampling method, and assigned to two intervention groups and one control group (15 nurses in each group). Reef's short-term psychological well-being and Walton's 32-item quality of work-life were used to measure dependent variables of the study. Then, mentalization-based therapy group received intervention in 8 sessions of 90 minutes as one session per week; and the treatment group based on emotion regulated therapy based on the Gross process model received the intervention in 8 sessions of 90 minutes, one session per week based on the protocol. No intervention was implemented for the control group. Data were analyzed using descriptive and inferential statistics in SPSS software.
Findings. Before the intervention, there were the highest scores for quality of work-life in the control group. At the end of the study and after the intervention, the scores of quality of work-life increased in all three groups, and no statistical significant difference was found between the groups. Before the intervention, the highest scores for psychological well-being was observed in the mentalization-based therapy group. (85.86±6.56), and after the intervention, although the psychological well-being scores of both interventions groups were higher than that of control group, but this diferrence was not statistically significant.
Conclusion. Based on the findings of this study, it seems that training sessions of mentalization-based therapy and emotion-regulated therapy based on the Gross process model improve the quality of work-life in nurses working in intensive care units, but the improvement was not statistically significant.

Abstract
Aim. This study was conducted to compare the prevalence of neck pain and disability among nurses in intensive care and general wards.
Background. Nursing is known as one of the ten occupations that are associated with musculoskeletal complications. In has been reported that neck and shoulder disorder are more common among nurses with high physical workload than those with low physical workload. So far, few studies have been performed on neck problems in nurses working at intensive care unit.
Method. In this cross-sectional descriptive-comparative study, 40 nurses from intensive care units and 40 nurses from general wards of Rasool Akram hospital, Tehran, Iran, were selected by convenience sampling method. Data collection in both groups was done through completing a checklist of demographic characteristics, Neck Disability Index (NDI) and Neck Pain and Disability Scale (NDPS) questionnaires by participants. The data was analyzed in SPSS version 22 using descriptive and inferential statistics.
Findings. The prevalence of neck pain and disability (measured by NDI and NPDS) in all nurses was 77.5 percent and 60 percent, respectively; 90 percent and 70 percent in nurses working at the intensive care units, and 65 percent and 50 percent in nurses working at general wards. The difference in scores measured by NDI was statistically significant between nurses working at the intensive care units and those working at general wards (P=0.014).
Conclusion. The prevalence of neck pain was significantly high in nurses, which could be due to their high workload that requires appropriate preventive measures and reduction of their physical workload.

Abstract
Aim. The aim of this study was to examine the effect of functional analytical psychotherapy on treatment adherence and self-care behaviors in female patients with acute myocardial infarction.
Background. The severity of cardiovascular disease is affected by cognitive and behavioral function in people experiencing acute myocardial infarction. Therefore, with effective and modern treatments for this problem, effective results could be expected.
Method. The research method was quasi-experimental pre-test post-test and follow-up design with control group. A sample of 30 women with a history of acute myocardial infarction who had been admitted to Seyed Al-Shohada Heart Hospital in Urmia, Iran, in 2021, were selected based on inclusion and exclusion criteria and randomly assigned to experimental (N=15) and control (N=15) group. Tsai et al. (2010) Functional Analytical Psychotherapy Package was implemented for experimental group in 10 sessions of 45 minutes duration. Before and after the sessions, and also, 3 months after intervention, both members of experimental and control groups completed Treatment Adherence Questionnaire and Self-Care Behavior Questionnaire as pre-test, post-test and follow-up measurements. Data were analyzed using mixed model analysis of covariance in SPSS Version 18.
Findings. The results showed that there was a statistically significant difference between experimental and control groups in term of the means of treatment adherence and self-care behaviors in pre-test, post-test and follow-up. Functional analytical psychotherapy had a greater effect on improving self-care behaviors (0.912) than treatment adherence (0.897) in female patients with acute myocardial infarction (P≥0.0001).
Conclusion. These results emphasize the effect of functional analytical psychotherapy in cognitive and behavioral domains in the treatment of female patients with acute myocardial infarction.

Abstract
Aim. The aim of this study was to determine the attitudes of intensive care unit nurses towards communicating with unconscious or conscious intubated patients unable to speak.
Background. Communication is one of the most important tools in patient care and is more important in intensive care units because many patients are unable to communicate verbally due to illness or treatment.
Methods. This descriptive cross-sectional study was conducted on 174 nurses working in intensive care units. They were selected by convenience sampling method. Data were collected by a researcher-made questionnaire through self-report. This questionnaire had two sections of views on communication with unconscious or conscious intubated patients unable to talk and factors related to non-communication with these patients which was completed either in paper or electronic form. The data were analyzed in SPSS version 26 using descriptive statistics and Pearson correlation.
Findings. The results showed that the majority of the studied units (94.3 percent) had a positive attitude towards communicating with patients with speech disabilities admitted to intensive care units. It was also found that large number of patients, nurse's reluctance to work in intensive care units, loading of unprofessional tasks, psychological fatigue, and no mastery in communicative skills are more associated with communicating with this group of patients.
Conclusion. According to the positive attitude of nurses towards communicating with unconscious or conscious intubated patients unable to speak, this positive attitude can be used to improve nurses' communication performance. In addition, it is necessary to improve the quality and quantity of communication with patients with speech problems through management measures to control some factors related to communicating with patients with speech impediments.

Abstract
Aim. The purpose of this study is to review studies that have investigated the effect of family-centered self-care program on the activity of people with cardiovascular disease after hospital discharge.
Background. Adherence to medication, diet and physical activity in people with cardiovascular disease is very crucial to prevent readmission, independence in daily activities, and complications.
Method. In this review study, a comprehensive search of scientific databases and search engines such as Science Direct, Scopus, PubMed, Google Scholar, and Medline using the keywords cardiovascular disease, adherence to treatment regimen, and family-centered self-care program in both Persian and English languages was done to find articles published between 2000 and 2020.
Findings. Family-centered post-discharge self-care program can be a principled and effective method to increase adherence to medication, diet and physical activity in heart people with cardiovascular disease.
Conclusion. One of the most important factors in effectiveness of self-care is active family participation and family-centered self-care, which can be effective in three areas after the discharge of people with cardiovascular disease.

Abstract
Aim. This study was conducted with the aim of investigating the effect of family-centered self-care program based on home visits on adherence to physical activity of patients with acute coronary syndrome
Background. Coronary artery disease is one of the most common cardiovascular diseases. The importance of physical activity as an important factor in controlling and preventing the recurrence of the disease in these patients. Adherence to physical activity in patients with acute coronary syndrome (ACS) has a significant effect on preventing re-hospitalization and reducing complications.
Method. In this semi-experimental study conducted in 2021-2002, 72 people with ACS were randomly divided into experimental and control groups (32 people in each group). For the control group, routine interventions, and for the experimental group, family-centered self-care was delivered. Data collection tools were demographic questionnaire and Beck's physical activity level questionnaire.
Findings. Before intervention, there was no statistically significant difference between groups in the mean score of adherence to physical activity. Immediately after the intervention, the mean score in the experimental and control group was 6.31±2.01 and 5.98±1.21, respectively, indicating a statistical significant difference between groups. One and half month after the intervention, the mean score in the experimental and control group was 9.14±1.44 and 78±0.9, respectively, showing a statistical significant difference between groups.
Conclusion. Family-centered self-care in patients with acute coronary syndrome is effective on adherence to physical activity of these patients. Therefore, it is recommended to use this educational method as one of the effective and non-pharmacological methods for people with ACS in medical centers and at home to improve the quality of life among these patients.