Iranian Journal of Nursing Research
Year:2010 | Volume:5 | Issue:16|Papers Count:10

Introduction: Cardiovascular diseases are the most common mortality cause world widely. Cardiac rehabilitation can reduce cardiovascular mortality and improves mental and cardiovascular conditions among cardiac patients. The aim of this study was to assess the impact of teaching cardiac rehabilitation program on electrocardiogram changes among patients with myocardial infarction.Methods: A semi-experimental study was conducted with 170 patients with myocardial infarction who were randomly allocated in two groups of intervention and control (85 patients in each group), 2008-2009. Participants were hospitalized in one of the hospitals affiliated to Arak University of Medical Sciences. Sample selection lasted 15 months. A cardiac rehabilitation program in two sessions was presented for experiment group. The first session was held at discharge time and the next 2-3 weeks afterward. Content of cardiac rehabilitation program was included a brief introduction to heart anatomy, exercise, controlling and modifying cardiovascular risk factors such as hypertension, diabetes mellitus, hyperlipidemia, diet, sexual relationships, mental health (e.g. Stress management) and medicine regime. Control group just received the regular care, not the rehabilitation program. A 12-lead electrocardiogram was obtained five times during six months.Results: It was revealed that normalizing of inverted t wave after six month in experiment group was significantly more than control group (P<0.05). Changes of ST segment and Q wave didn’tt show any significant differences between experiment and control groups.Conclusion: The study indicated that teaching cardiac rehabilitation program accelerates normalizing inverted t wave. It clearly demonstrates the valuable outcomes of teaching cardiac rehabilitation program to patients with myocardial infarction.

Introduction: Schizophrenia is one of the complex psychiatric disorders. Although the antipsychotic agents are the main treatment for the disorder, but psychological interventions are effective on clinical symptoms as well. The study aimed at assessing the effect of spiritual-religious group therapy on mental status of schizophrenic patients.Methods: Using semi-experimental study method 67 patients with schizophrenia were selected through Randomized Permuted Block method. They were divided to intervention (32 patients) and control (35 patients) groups. Intervention group were participated in 12 sessions of Spiritual Religious Group Therapy within 4 weeks (3 sessions per week). Each session lasted one hour. Data was collected through a Demographic Information Questionnaire and Brief Psychiatric Rating Scale (BPRS). Statistical Analysis was carried out, using Paired T-Test and One Sample T-Test.Results: Significant differences were found between patients’ mental status before and after the intervention (P=0.001), whilst the difference was not significant in the control group (P=0.268). There were no significant differences between intervention and control groups prior to the intervention (P=0.093).Conclusion: Spiritual Religious Group Therapy can be effective on improvement of the mental status of schizophrenic Patients.

Introduction: Although improving clinical decision making skills is declared as one of the main aims of nursing education, evidences show that it is not presented effectively within nursing education programmes. The present study aimed at exploring clinical decision making process among last year nursing student.Methods: Using qualitative method (Grounded theory), six focus groups and 12 sessions of participants’ observation were conducted with a purposeful sample of 32 last year nursing students. The data were analyzed through constant comparative analysis.Results: Participants believed competent clinical instructor, applicable knowledge, clinical experience; appropriate setting for clinical education and professional self confidence are the main influential factors on students’ clinical decision making.Conclusion: Acquiring professional self confidence is the most important factor in experiencing and learning clinical decision making. The study revealed nursing student believe that not acquiring applicable knowledge and appropriate clinical experiences have impact on low professional self confidence required for clinical decisions. Therefore they are not satisfied with their gained competencies in clinical decision making. The result of this study showed that nursing students were not satisfied with the competency in clinical decision making. They experience low professional self-confidence as a result of feeling incompetent due to lack of applicable knowledge, suitable clinical experiences and conductive clinical learning climate.

Introduction: Venipuncture is one of the most painful procedures in hospitalized children and reducing the pain is an important aim of nursing interventions. This study was designed to compare effectiveness of EMLA cream and local refrigeration on reducing venipuncture-related pain in hospitalized children in Children’s Medical Center.Methods: An interventional study was conducted with 90 hospitalized children ranging in age from 3 to 12 years old who had venipuncture in urology unit of Children’s Medical Center. They were randomly allocated in three groups of intervention with EMLA cream, intervention with local refrigeration, and non-intervention groups. The first two groups received the interventions prior to venipuncture. Pain intensity was measured after venipuncture through FACES, a self-report scale and CHEOPS scale for Nurse’s observations. All statistics were computed using the SPSS software, using parametric and nonparametric statistical tests, Mann-Whitney and Kruskal-Wallis tests.Results: The mean and standard deviation of pain intensity scores based on FACES scale in EMLA, local refrigeration and control groups were 3.26±2.79, 8.23±2.39 and 7.06±2.27, respectively. The corresponding values for CHEOPS scale were 7.40±2.15, 4.26±2.81 and 9.35±2.17. The between groups difference was statistically significant according to both scales (P<0.00). EMLA and local refrigeration significantly reduced the venipuncture-related pain, compared to controls. There was no significant difference between EMLA and refrigeration groups in reducing the pain.Conclusion: Both refrigeration and EMLA are effective on reducing venipuncture-related pain in children. So, refrigeration, as a non pharmacological, cost effective, and available method, is recommended to manage procedural pain in pediatric patients.

Introduction: Coronary angiography is a definite diagnostic evaluation for coronary artery disease and valvular heart disease. It is necessary to provide information to such patients in order to maximize their comfort and tolerability to the invasive procedure. The study aimed at assessing the effect of patients' education by video on comfort and tolerability of patients undergoing coronary angiography.Methods: Using quasi- experimental method with a pretest-posttest design, 128 patients with coronary artery diseases randomly assigned to two groups of control and experiment. The sample hadn’t any experience of the procedure before. Control group received routine oral education by nurses and experimental group received an informative video on coronary angiography procedure as well as pre and post angiography interventions. Data were gathered through a 10-point rating visual analog scale (VAS) for comfort level and a 4-point rating scale to measure tolerability.Results: No significant difference was found between the two groups, concerning demographic variables. It was revealed that the comfort level (P<0.001) and tolerability of the patient (P<0.05) in experimental group was higher than control group two, four and six hours after angiography (P<0.05).Conclusion: The study indicated providing information on angiography through video could enhance patients’ comfort and tolerability to the invasive procedure. It could result in shortened stay at hospital and increased satisfaction of patients.

Introduction: Establishing an effective communication with patients is an essential aspect of nursing care. However, most of studies described the nurse-patient relationship as weak. Recognition of barriers in nurse-patient’s effective communication from their point of view could facilitate the actions need to be taken for removing such barriers. The study aimed at assessing barriers of nurse-patient’s effective communication from nurses and patients’ viewpoints and to compare them.Methods: This descriptive - analytic study was undertaken in 2008, with a sample of 80 nurses and 80 patients drawn from three educational hospitals in Ahvaz city. They were selected by convenience sampling. Data were gathered through a questionnaire with 30 questions for nurses and 15 questions for patients on a 5-points Likert rating scale.Results: It was found that "nursing works overload" (77.5%), "hardship of nursing tasks" (73.75%), "deficiency of welfare facilities for nurses"(67.5%), "physical and emotional fatigue" (66.25%) and "not appreciating nurses" (62.5%) were reported by nurses as the main barriers of effective communication. Patients considered "nurses’ unfamiliarity with local language" (40%), "Nurses’ bad temper" (33.75%), "sex difference with nurses" (32.5%), "Patients’ transmitted diseases" (28.75%) and "lack of therapeutic and welfare facilities for patients" (25%) main barriers of effective communication.Conclusion: The study revealed there are some congruency and discrepancy between nurse’s and patient's viewpoints in ranking barriers. Thus health manager should put their attempts on eliminating or modifying the most important barriers announced by nurses and patients, especially on factors which both groups reported.

Introduction: Inhaled therapy (Sprays) is one of the basic strategies for treatment of asthma. Spray application methods play a significant role on effective asthma management. Therefore education on how to use inhaled therapy is essential.The present study aimed at comparing the impact of education through concept mapping with face to face education on spray application of children with asthma.Methods: A controlled clinical trial was conducted with 80 asthmatic children, ranging in age from 6 to 12 years old. They were selected through random allocation.Control group were educated through face to face method and experimental group by visual concept mapping. Pre-test and post-test was taken before and 30 minutes after the intervention. A follow up post-test was taken one month later.Results: Mean scores of second post-test was 6.7 (±2) for control group and 9.5 (±0.7) for experimental group. Independent t-test demonstrated a significant difference between groups (P<0.001). Moreover, repeated measured ANOVA revealed a rising trend in learning of both groups, but the progress was more obvious in experimental group (P<0.001).Conclusion: Concept mapping was more effective in educating children with asthma using inhaled therapy than face to face method. Therefore, pediatric nurses and other therapists can employ visual concept mapping in order to increase the effectiveness of their education on spray application of children with asthma.

Introduction: Cardiovascular disease is one of the important mortality causes in developed country of the world and so in Iran. Coronary Artery bypass graft surgery as a lifesaving intervention in cardiac patients may presents a number of challenges for patients and theire family caregivers. Little is known about the experience of caring for this patient. The purpose of this study was to describe the lived experiences of family caregivers of coronary artery bypass graft.Methods: This is a qualitative study with phenomenology method. Using phenomenological methods, 14 family caregiver were interviewed at clinic or home during one year post discharge period.Results: Five them emerge from participant experiences encompass; pressure of role, exposure to tension, resistance against vulnerability, functioning, and need.Conclusion: The research finding showed that the patient,s family faced with many stressor agents duration their caregivering period that this stress agents provoke somatic and mental reaction. Inappropriate interaction of medical team exacerbated this problem. In other hand, the devout belives, appropriate information and provided needs had important effect on protect them. Having an appropriate communication with patients and family caregivers should hold in nursing plans.