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Showing 18 results for Pain
Jaleh Mohammad Aliha, Nayerreh Behroozi, Hamid Peyrovi, Abbas Mehran,
Volume 2, Issue 2 (9-2013)
Abstract
Abstract Aim. The aim of this study was to examine the effect of foot reflexology massage on incisional pain in thoraco-abdominal surgery patients admitted to surgery intensive care unit. Background. Although the most commonly used method of pain relief is pharmacologic, the medications prescribed excessively for severe and chronic pain in patients have side effects and non-pharmacological methods of pain relief may be useful. Method. In this quasi-experimental study, 102 patients within the age range of 25 to 50 years without any other surgical complication, and normal feet which have undergone thoraco-abdomical surgery were enrolled. They were randomly allocated into 3 equal groups: massage group, pseudo-massage group and control group. The pain was measured Visual Analogue Scale (VAS) before, right after, 10 minute and 24 hours after the treatment. Other data was extracted from medical records. The information was analyzed by SPSS using appropriate statistical tests. Findings. According to the findings, there were no statistically significant difference between the groups in terms of age sex marital status educational levels underlying diseases and type, duration and severity of the surgery. The pain score was not significantly different between groups before and right after the intervention. However, 10 minutes and 24 hours after the intervention, pain score was lower in the massage group. The use of pharmacological analgesics had also reduced in the massage group. Conclusion. Foot reflexology was effective on incisional pain after thoraco-abdominal surgery. Nurses can use this intervention to improve patient comfort and decrease pain medications administration in thease patients.
Mohamad Abbasi, Mohamad Norozzade, Bahman Aghai, Ali Maarefvand, Mohammad Nategh, Yaser Saaid,
Volume 2, Issue 3 (12-2013)
Abstract
Abstract Aim.The aim of this study was a review on common pain assessment tools which are used in critical care units. Background. Pain is an unpleasant physiological and psychological feeling and a complex phenomenon which is common among patients in critical care units. Nowadays, the importance of pain is to the extent that the American Pain Association named it as the fifth vital sign. Pain relief is an important issue to improve patient outcomes in the intensive care units. Accordingly, nurses must be sensitive in precise pain assessment. Method. In this review article, six pain assessment tools were selected based on the keywords "pain", "pain relief", and "pain assessment tools" from the databases Ovid, PubMed, Cochran, CINHAL, Science Direct, Scopus, and Google Scholar. Findings.Among articles on pain assessment tools, 40 articles were selected. There are six commonpain assessment toolsused in critical care units includingCritical Pain Observation Tool (CPOT),Behavioral PainScale(BPS), behavioralpain assessmenttool(FLACC), Non-VerbalPainScale)NVPS), Pain Assessment and Intervention Notation (PAIN) algorithm and Nonverbal Pain Assessment Tool (NPAT) which are used in adult and pediatric patients with verbal impairment and for painfulprocedures. Conclusion. According to the importance of pain management in intensive care units, nurses must particularly apply valid tools for pain assessment to facilitate healing process and use of pain medications properly.
Touraj Babaee, Roghaye Sadeghi, Hooman Bakhshandeh,
Volume 3, Issue 2 (9-2014)
Abstract
Abstract Aim.The purpose of this study was to examine the effect of patient education on postoperative pain perception in patient undergoing Coronary Artery Bypass Graft (CABG). Background.Pain is a common complication after CABG surgery. Non-pharmacological methods are more favorable than pharmacological agents. Method.In this quasi-experimental study, 72 patients who were scheduled for elective CABG surgery were randomized to experimental (n=36) and control group (n=36). Experimental group received educational intervention about pain control, one day before surgery (20-30 minutes duration), while control group received no intervention. Following transferring to the ICU and 2 hours after extubation, patients’ pain intensity wasmeasured by Johnson’s numerical scale. The measurements wererepeated twice withanintervalof threehours. The type and dosage of pain medication administered during ICU stay were recorded. To analyse the data, descriptive(mean and standard deviation, frequency distribution and percentage) and analytical statistics (Chi-square and Mann-Whitneytest) were used. Findings.There was no statistically significant difference between two groups in terms of demographic characteristics. Two hours after extubation, there were no statistically significant difference between experimental and control group in the intensity of pain (P=0.313). Pain intensity was significantly lower in experimental group than control group, 5 hours (P=0.015) and 8 hours (P=0.006) after surgery. The results also showedthat the amount ofanalgesics used to relieve post-operativepain was significantly lower in experimental group than control group (P=0.046). Conclusion.Patient education about pain control may have positive effects on postoperative pain in patients undergoing CABG surgery. This intervention could serve as an effective strategy for nurses to improve pain management among these patients.
Mohammad Hadi Sarvari, Hamid Chamanzari, Gholam Hossein Kazemzadeh, Sayed Mostafa Mohsenizadeh, Ali Dashtgard,
Volume 3, Issue 3 (12-2014)
Abstract
Aim. This study aimed to examine the effect of local thermotherapy on pain severity in patients with chronic peripheral arterial occlusive disorders.
Background. Chronic peripheral arterial occlusive disorders are among the most commonly and disturbing diseases which mainly affect the lower extremities. Chronic peripheral arterial occlusive disorders are the most common causes of disability. Many of patients with chronic peripheral arterial occlusive disorder suffer from pain.
Methods. In this randomized clinical trial, 60 patients with chronic peripheral arterial occlusive disorders, referred to specialized unit of Mashhad Imam Reza Hospital, were recruited through convenience sampling and randomly allocated to control (n=30) and intervention group (n=30).
A questionnaire including information about demographic characteristics and disease status were completed for all patients. Then, the pain severity of patients was measured before the intervention. In the experimental group, the damaged limb of patients (from below of knee to fingers) put in the hot water (41 ° C) for 20 minutes. After thermotherapy, the pain severity of patients in the experimental group was measured again. Intervention was implemented for 5 consecutive days. The patients in control group received only routine medical treatment in the ward during 5 days and each day, their pain severity were measured. Data were analyzed by using SPSS 14 and descriptive and inferential statistics.
Findings. The mean pain severity of patients after the intervention showed a statistically significant decrease (P<0.0001). The mean pain severity of patients in control group during 5 days showed no statistically significant difference.
Conclusion Thermotherapy with hot water significantly decreases pain severity of patients with chronic peripheral arterial occlusive disorders.
Seyede-Maryam Shafiee-Darabi, Hamidreza Khankeh, Masoud Fallahi-Khoshknab, Pourya-Reza Soltani,
Volume 3, Issue 4 (3-2015)
Abstract
Aim. This study was conducted to examine the effect of acupressure on severity of pain and fatigue in patients with chronic heart failure.
Background. Patients with chronic heart failure experience high levels of pain and fatigue. Acupressure is a simple, inexpensive and non-invasive method which may reduce the pain and fatigue in patients with chronic heart failure.
Method. In this single blind randomized clinical trial, 72 patients with chronic heart failure were recruited. Subjects were equally divided into two groups of experimental and placebo, by random allocation method. Then visual analogue scale and fatigue severity scale was used to evaluate the severity of pain and fatigue in each group. The members of experimental group were under acupressure in KI3 , GV20 and CV6 point for 3 minutes bilaterally. In addition, the participants were instructed to perform acupressure in same point three times a day for four weeks. Subjects in placebo group were trained to touch the points. Four weeks after intervention, the severity of pain and fatigue was measured in both groups. The data were analyzed by SPSS.
Findings. The study findings showed no statistically significant difference between the groups in terms of demographics, and severity of pain (p=1.000) and severity of fatigue (p=0.285) before intervention. After four weeks of intervention, a statistically significant relief on severity of pain (p=0.006) and fatigue (p≤ 0.0001) was seen in experimental group compared with placebo group .
Conclusion. Acupressure can be effective in decreasing severity of pain and fatigue in people with chronic heart failure.
Nahid Aghdaii, Zahra-Sadat Navabi, Rasoul Azarfarin,
Volume 4, Issue 2 (9-2015)
Abstract
Aim. The aim of this study was to evaluate the effect of using “Pain Assessment Tool” by nurses on analgesics requirement and patient’s satisfaction after coronary bypass graft surgery.
Background. One of the main duties of caregivers in ICU is relieving patients’ pain. Using "Pain Assessment Tool" may have a positive effect on the choice of analgesics and dosage adjustment with patients’ requirements. More research is still needed.
Method. In a clinical trial, 153 hospitalized patients in the intensive care unit were selected randomly and were divided into two experimental (n=77) and Control group (n=76). The Pain Assessment Tool and pain management for 48 hours were implemented for conscious patients. Routine measures were taken into account for control group and the severity of pain and analgesic injection for experimental group were determined. In both groups, the amount of analgesics administered for pain relief, and patient satisfaction were recorded. Data were analyzed by SPSS version 16.
Findings. The use of Pain Assessment Tool increased the number of recipients of analgesic drugs and reduced their dosage over 48 hours in the experimental group. Also, the satisfaction of pain relief was higher in the experimental group than the control group (p<0.0001).
Conclusion. The findings of this study demonstrate the positive effect of Pain Assessment Tool on pain control, proper use of analgesics, prescribing the proper dose of analgesics based on patients’ pain and satisfaction improvement. The measurement of pain severity using Pain Assessment Tool, before and after analgesics administration is suggested.
Zhra Yousefi, Kobra Rahzani, Korosh Rezaei, Kianoosh Hoseini,
Volume 4, Issue 3 (12-2015)
Abstract
Aim. This study was conducted to examine the effect of deep and slow breathing on pain and pain outcomes during arterial sheath removal after undergoing coronary angioplasty.
Background. During the last 30 years, coronary angioplasty has been the most common method for management of coronary artery stenosis. Lack of control or treatment of the pain caused by arterial sheath removal may have some consequences, most notably increased heart rate and blood pressure in patients.
Method. This is a clinical trial study conducted on 60 patients undergoing coronary angioplasty, hospitalized between April and August 2015 in the catheterization laboratory of Shariati hospital, Tehran, Iran. Patients were divided into two groups using random number table. The intervention was slow, deep breathing techniques by inhale and exhale ratio of 4 to 6. Data were analyzed using SPSS.
Findings. Immediately and 5 minutes after sheath removal, the average pain score in the intervention group was significantly lower rather than control group (P<0.05). There was no statistically significant difference between groups in terms of blood pressure and heart rate average. The average number of vasovagal attack was significantly different between the groups. The average number of vascular complications was not significantly different between intervention and control group.
Conclusion. The use of slow and deep breathing and relaxation technique is effective on pain management and the incidence of vasovagal attacks after arterial sheath removal, and can be used as an easy and safe method to decrease patients’ discontent caused by pain.
Ahmad Valikhani, Majdoddin Fathi, Mohsen Salary Salageghe, Farhad Khormaee,
Volume 5, Issue 3 (12-2016)
Abstract
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.
Faezeh Soltani, Meysam Chahqui, Mansoor Arab, Seyed-Fakhraldin Hosseini, Fatima Dabbagh,
Volume 5, Issue 4 (3-2017)
Abstract
Abstract
Aim. This research aims to investigate the effects of spiritual care on pain in patients undergoing coronary artery bypass grafting (CABG) surgery.
Background. Pain as a significant problem in patients undergoing CABG requires nursing care. Because of side effects from opioids, it is important to use non-pharmacological approaches such as spiritual care to control pain in these patients.
Method. This clinical trial was performed on 70 patients after CABG. Data collection tools included a demographic questionnaire, and McGill Pain questionnaire. The patients were randomly assigned into two groups of experimental and control. Spiritual care program in the experimental group included supportive presence, supporting patient’s rituals, and using supportive systems for 3 days. Pain levels were measured before and after intervention for both groups. The control group did not receive any intervention. Data were analyzed in SPSS version 20.
Findings. There was no statistically significant difference between the two groups in terms of in demographic characteristics. Before intervention, no statistically significant difference was found between the pain scores of the groups, however, after the intervention, pain scores were significantly lower in the experimental group than in the control group. There was also a statistically significant difference between the pain scores of the experiment group before and after the intervention. Such a difference was not found in the control group.
Conclusion. Spiritual care program reduced pain in patients undergoing CABG. With regard to the results of the present study, it is suggested that nurses include religious-spiritual care in nursing care plan as a helpful way to control pain in these patients.
Masomeh Fifaie, Afsaneh Kojaie-Bidgoli, Hasan Rajabi Moghadam, Mohammad-Sadegh Pourabbasi, Mojtaba Sehat,
Volume 6, Issue 2 (9-2017)
Abstract
Abstract
Aim. The aim of this study was to examine the effect of changing position on back pain after cardiac catheterization.
Background. Prolonged bed rest after coronary angiography produces back pain.
Methods. This was a quasi-experimental study conducted on 98 patients who had been admitted for coronary angiography in Shahid Beheshti Hospital of Kashan, Iran, in the year 2014. Patients were randomly allocated to intervention and control group. In this study, data collection form consisted of three sections including demographic information, numerical pain scale, and bleeding and hematoma control checklist. Patients in the control group received routine care after coronary angiography including bed rest for 6 hours without movement of effected limb. However, patients’ position in the intervention group was intermittently changed during the first 6 hours after catheterization. Patients in the intervention and control group were assessed in terms of severity of pain, and bleeding and hematoma, immediately after moving to the ward, and then two, four and six hours after angiography. The data were analyzed in SPSS version 11.5 using descriptive and inferential statistics.
Findings. The result showed that there were statistically significant differences between the intervention and control group in terms of mean score of back pain immediately after moving to the ward (p≤0.0001), and 4 hours (p≤0.0001) and 6 hours (p≤0.0001) after angiography.
Conclusion. In this study, changing position of patients after angiography reduced back pain in patients without causing any complication like hematoma and bleeding; therefore, it can be concluded that applying this intervention could be considered as a convenient way to relieve back pain in patients after coronary angiography.
Seyed-Habibollah Hosseini, Rahim Karamizadeh, Tabandeh Sadeghi, Ali Esmaeili,
Volume 6, Issue 3 (12-2017)
Abstract
Abstract
Aim. This study was carried out to compare the effect of trinitroglycerin (TNG) spray and sublingual pearl on chest pain severity and some physiological indices of people with chest pain visited by emergency medical services.
Background. Glyceryl trinitrate is used as an anti-anginal vasodilating agent with various forms including spray and pearl with probable different therapeutic effects.
Method. In this quasi-experimental study, 80 patients with chest pain were recruited through convenience sampling and then allocated to pearl and spray groups by minimization method. After arriving at the patient's bedside, vital signs and chest pain severity were measured and recorded, then the drug was administered every 5 minutes for 3 times; thereafter, the measurements were repeated. The data analyzed in SPSS software 1) using descriptive and inferential statistics.
Findings. The results showed that after intervention, the mean score of pain in pearl and spray groups were 6.05±0.98 and 5.60±1.25, respectively. There was no statistically significant difference between groups in terms of pain score. Whereas after intervention, the mean systolic and diastolic pressure in pearl group was significantly lower than the spray group, the heart rate in both groups were increased.
Conclusion. Nitroglycerin in the pearl form has the same effect as spray form in relieving chest pain. According to the circumstances and drug accessibility, emergency staff might use every two forms of Nitroglycerin.
Mohammad Javadinejad, Masoumeh Zakeri Moghaddam, Samaneh Ahmadi, Maryam Tahmasvand, Khatereh Seylani,
Volume 7, Issue 3 (12-2018)
Abstract
Abstract
Aim. This review study aims to investigate the impact of reducing Door-to-ECG (DTE) time on on morbidity and mortality of patients with chest pain referred to emergency department.
Background. Chest pain is the second most common reason for referral to an emergency unit. According to American Heart Association, all patients with chest pain presenting to the emergency ward should be approached with an ECG within 10 minutes of entrance to the emergency department. This is considered as the first line of diagnostic tests for myocardial infarction.
Method. In this narrative review study, several databases and search engines including SID, Pub Med, Google Scholar, Web of Science and Scopus were used to find the articles published between 2000 and 2018. The keywords used to search articles were “Door to ECG”, “chest pain”, “emergency unit” and “triage”. The articles selected for review were interventional or descriptive in terms of design, in Persian or English, with available full text. The criterion for selecting articles was the similarity of the their subject with the search keywords including Door to ECG (DTE) time and triage and their value in the early diagnosis and treatment of coronary disorders.
Findings. A total of 20 articles were found. After removing the articles that didn’t meet the inclusion criteria, 11 articles related to the subject of the study remained in review. The significant outcomes of timely triage, appropriate time to perform ECG, barriers to access and suggestions for faster treatment by the system especially the role of nurses, were investigated.
Conclusion. The reduction of triage time and Door to ECG (DTE) time as well as the role of the nurse in those cases are associated with a reduction in the morbidity and mortality of cardiac patients.
Farzane Sedighi, Maasoumeh Barkhordari Sharifabad, Khadijeh Nasiriani, Hossein Fallahzadeh,
Volume 7, Issue 3 (12-2018)
Abstract
Abstract
Aim. The purpose of this study was to examine the effect of bed angle on back pain, urinary retention and vascular complications after coronary angiography.
Background. To minimize the severity of low back pain and urine retention after angiography, modalities such as changing position, changing bed angle, and early out of bed have been used, but there is still controversy about the appropriate bed angle that reduces cardiovascular complications and at the same time provides patient comfort.
Method. This study was a randomized clinical trial conducted on 120 patients after angiography in cardiology and angiography wards of Shahid Sadoughi Hospital, Yazd, Iran, in 2018. A total of 120 patients who were candidates for angiography were randomly divided into control and experimental group. After angiography, for the control group, the bed angle was zero, and for the experimental group, the bed angle was set at 30 degrees, from entry to the ward for 4 hours. Data collection tools included demographic and clinical information questionnaire, numerical scale for measuring severity of pain, hematoma and hemorrhage recording form and urinary retention observation and recording form. Data analysis was performed in SPSS Version 20 using descriptive and inferential statistics.
Findings. The mean score of back pain in the experimental group, immediately and four hours after angiography was 0.166±0.767 and 0.216±55.0, respectively, which was lower than that of control group (0.233±0.615 and 0.433±0.927, respectively), but the difference was not statistically significant. Also, there was no statistically significant difference between groups in terms of urinary retention, immediately and 2 hours after angiography. There was no statistically significant difference between groups in terms of vascular complications (hematoma and hemorrhage).
Conclusion. The results of this study did not show any evidence that 30 degrees bed angle adjustment have any different effect on pain severity, urinary retention, and vascular complications of the zero degree bed angle. It is recommended that after angiography, the angle of the bed be set to zero or 30 degrees according to the patient's comfort and preference.
Tahereh Najafi Gezelje, Seyedeh Marziyeh Moosavi, Peyman Saberian, Shima Haghani,
Volume 8, Issue 1 (3-2019)
Abstract
Abstract
Aim. The present study aims to determine the performance of “Tehran 115 medical emergency” dispatchers in providing services to patients with chest pain.
Background. Chest pain is one of the most common problems for which individuals call medical emergency services. The pace, accuracy, and integration of services by medical emergency dispatchers are highly important to decrease mortality and disability rates.
Method. A cross-sectional descriptive study was carried out on 397 voice records of 80 dispatchers in “Tehran 115 medical emergency services” about chest pain in January 2019. Data gathering was done using the Dispatcher Performance Assessment Checklist. All the obtained scores by the checklist were analyzed in SPSS (V.22).
Findings. All voice records demonstrated an acceptable performance of the dispatchers. The mean score of performance in consultation section was 18±2.66 ranged from 9 to 20. The mean score of performance in key questions section was 35.95±2.16 with a score range from 28 to 38. The total mean score of performance was 53.95±3.57 with a score range from 43 to 58. In addition, employment status (P=0.039) and work experience (P=0.020) were significantly related to dispatchers’ performance in terms of assessing chest pain.
Conclusion. Assessment according to the checklist items and provision of proper consultation services to the patients and patient companions by the 115 dispatchers resulted in a better and timely diagnosis, faster dispatch of ambulance, less damages sustained by heart patients, and prevention of death. The findings emphasized on the necessity of adhering to the questions algorithm and uniform work procedure by dispatchers nationwide. This should be an integral part of telephone triage. Observation of national standard prevents probable damages to patients due to wrong or personalized decision making.
Vida Mohamdiheris, Ali Shakerdolag, Ali Khademi, Ali Zeynali, Naser Safai,
Volume 9, Issue 1 (3-2020)
Abstract
Abstract
Aim. The aim of this study was to examine the effect of acceptance and commitment therapy on chronic pain, resilience and self-care in women with coronary artery disease.
Background. Women with cardiovascular disease have many problems in the field of physical and mental health and one of the effective methods to manage these problems is treatment based on acceptance and commitment.
Method. The study was conducted based on a quasi-experimental pretest-posttest with a control group design. The statistical population included all women with coronary artery disease who referred to Tabriz Heart Hospital within six months in late 2019 and early 2020. After reviewing the clinical interview, women were selected to enter the study based on inclusion criteria and randomly assigned to experimental (n=15) and control group (n=15). Data were collected using the Van Korf et al. Chronic Pain Scale, the Connor and Davidson Resilience Questionnaire, and the Rigel et al. Self-Care Scale. Data were analyzed by multivariate analysis of covariance in SPSS version 19.
Findings. The results showed that acceptance and commitment therapy had a statistically significant effect on chronic pain, resilience and self-care of women with coronary artery disease. Acceptance and commitment therapy reduces chronic pain and improves and increases resilience and self-care in women with coronary artery disease.
Conclusion. Acceptance and commitment therapy improved resilience and self-care and reduced chronic pain in women with coronary artery disease. It is recommended that therapists and health professionals use acceptance and commitment therapy along with other educational and therapeutic methods to improve health-related characteristics.
Sara Lotfian, Fatemeh Kermani, Dr Pardis Moradnejad, Haleh Dadgostar, Maryam Talebi,
Volume 10, Issue 1 (3-2021)
Abstract
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.
Vida Mohamdiheris, Ali Shakerdolag, Ali Khademi, Ali Zeynali, Naser Safai,
Volume 11, Issue 1 (3-2022)
Abstract
Abstract
Aim. The aim of this study was to compare the effect of acceptance and commitment-based therapy and emotion regulation education on chronic pain and self-care in women with coronary artery disease.
Background. Research shows that coronary heart disease is one of the leading causes of death and disability in the world, which reduces the useful efficiency of people. Psychological factors can change many aspects of patients' lives and relationships.
Method. The research design was quasi-experimental pre-test-post-test with control group. The statistical population in this study included all women with coronary artery disease referred to Tabriz Heart Hospital in 2020. Women who had inclusion criteria were selected and randomly assigned to the first experimental group (n=15), the second experimental group (n=15) and the control group (n=15). The first experimental group (emotion regulation education) was subjected to 12 sessions of 90-minute duration (three sessions per week), The second experimental group (acceptance and commitment-based therapy) received 8 sessions of 90-minute duration, and the control group did not receive any intervention. The chronic pain scale of Von Korff et al. and the self-care scale of Rigel et al. were used to collect the data. Data were analyzed by multivariate analysis of covariance and LSD post hoc test in SPSS Version 21.
Findings. The results showed that treatment based on acceptance and commitment and emotion regulation education have an effect on chronic pain and self-care of patients with coronary artery occlusion (P ≤0.0001), as they reduced chronic pain and improve patients' self-care. The results also showed that acceptance and commitment therapy has a greater effect on chronic pain and patients' self-care than emotion regulation education.
Conclusion. Attention to acceptance and commitment therapy and emotion regulation education can play a role in reducing the psychological problems of women with coronary artery disease.
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.
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