Cardiovascular Nursing Journal
Year:2020 | Volume:9 | Issue:1|Papers Count:25

Aim: The aim of this study was to investigate the mediating r ole of per ceived str ess in the r elationship between self-efficacy and quality of life in people with cardiovascular patients. Background: Car diovascular disease as a chr onic and debilitating physical condition is one of the most common causes of death and can affect the quality of life. In this regard, it is necessary to identify variables related to quality of life in these patients. Method: The pr esent study was a descr iptive-correlational study using structural equation modeling. The statistical population of the present study included all patients with cardiovascular disease referring to hospitals for cardiology and heart surgery, and cardiac rehabilitation centers in Tehran, Iran in 2019, of which 151 people were recruited based on inclusion criteria. Data collection tools included the Sullivan Cardiac Self-Efficacy Questionnaire, Cohen's Perceived Stress Questionnaire, and Quality of Life Scale (SF-36). Findings: The r esults showed that negative per ception of str ess and positive per ception of str ess had a statistically significant negative and positive relationship with dimensions of quality of life, respectively. Self-efficacy had a statistically significant positive relationship with dimensions of quality of life. Perceived stress also mediated the relationship between self-efficacy and quality of life dimensions. Conclusion: In planning necessar y measur es to impr ove the quality of life in people with car diovascular patients, it would be helpful to develop programs to strengthen self-efficacy and reduce stress.

Aim: This study was conducted to examine the relationship between magnesium blood levels and postoperative bleeding in patients undergoing elective Coronary Artery Bypass Grafting (CABG) Surgery. Background: Decline in Serum magnesium following cardiac surgery is an important issue and postoperative bleeding is among concerns associated with postoperative care in open heart surgery. It seems that coagulation disorders related to magnesium are dose-related. Method: In this descriptive correlational study, 120 patients undergoing CABG surgery using cardiopulmonary bypass machine were enrolled. All the patients were similar regarding the process of anesthesia and surgery. After surgery, when transferring to the intensive care unit, a blood sample was obtained from patient and sent to the laboratory to measure the magnesium blood levels. The amount of blood drainage in chest bottle of patient was recorded. The data were analyzed in SPSS version 20 using descriptive and inferential statistics. Findings: There was a statistically significant inverse correlation between magnesium blood levels and postoperative blood drainage (r=-0. 17, P=0. 046). There was also a statistically significant correlation of Prothrombin Time (PT) and Partial Thromboplastin Time (PTT). Conclusion: Magnesium blood level is influential on blood drainage in postoperative period as well as antiarrhythmic effect. It seems there is no concern about increasing blood drainage following infusing magnesium for patients under CABG surgery.

Aim: The purpose of this study was to examine the health promoting behavior model based on spiritual health, social support and mental capital in people with cardiovascular disease. Background: Cardiovascular disease affects various aspects of life, including physical, emotional, social and functional health, and one of the factors that affect the quality of life of people with cardiovascular disease is the health promoting behaviors. Method: In this correlational study, path analysis model was used to examine hypotheses. The statistical population of this study consisted of all people with cardiovascular disease referred to medical centers in Qom in year 2020, out of which 200 people were selected by convenience sampling. Research measurement tools included Lutz Psychological Capital Questionnaire (2007), Zimet et al. Multidimensional Perceived Social Support Scale (1998), Palutzian et al. (1983) Spiritual Health Questionnaire and Walker et al. (1987) Health Promoting Behaviors Questionnaire. Data analysis was performed in AMOS. 22 and SPSS. 22 software using Pearson correlation method and path analysis model with. Findings: The results showed that spiritual health (β, =0. 21, P<0. 002) and social support (β, = 0. 17, P<0. 013) had an effect on mental capital. Psychological capital also played a mediating role in the relationship between spiritual health and social support with health promoting behavior (RMSEA=0. 067, AGFI=0. 98). Conclusion: It could be concluded that spiritual health, social support and psychological capital play an important role in health promoting behavior of people with cardiovascular disease. Therefore, in developing therapeutic programs for these patients, it is better to emphasize and pay attention to familial, psychological, religious, social and health factors.

Aim: The aim of this literature review was to investigate the importance of adherence to diet in and nutritional recommendations for patient after coronary artery bypass graft surgery. Background: Nutritional patterns after heart surgery are among the most important aspects of care that is provided by the nurse. Due to the importance of this issue, various studies have been conducted to focus on principles of proper nutrition after coronary artery bypass graft surgery and the necessary recommendations. Method: The present review study was conducted through searching out databases and search engines Pub Med, SID, MagIran, Web of Sciences, Cochrane Library, CINHAL, OVID, Up-to-date, and Scopus without time limit using the keywords Coronary artery bypass graft surgery, Adherence to nutrition therapy, Cardiovascular disease, Survival rate, Complications of heart disease and nursing care, Diet, and Nutritional support. Out of a total of 103 articles, 65 articles with accessible full text entered the qualitative review stage, of which 51 articles entered the literature review. Findings: The use of appropriate dietary approach such as consumption of fruits and vegetables, nuts and nuts, consumption of dairy products, fish and cooked and steamed foods should be the first priority of patients after coronary artery bypass graft surgery. They should avoid of fried and processed materials as much as possible. Conclusion: Nurses' familiarity with the principles of nutrition and providing nutritional solutions, based on the latest guidelines published, to patients after coronary artery bypass graft surgery plays an important role in reducing complications and readmission of patients.

Aim: This study was designed to investigate the association of obsessive-compulsive disorder with cardiac symptoms in people with acute coronary syndrome. Background: The prevalence of cardiovascular disease and its morbidity and mortality has increased. The importance of psychological factors, especially anxiety disorders, in development of cardiovascular disease necessitates examining the relationship between obsessive-compulsive disorder and cardiac symptoms in people with acute coronary syndrome. Method: This is a cross-sectional descriptive correlational study. The statistical population included all cases of acute coronary syndrome referred to the selected hospitals of Isfahan University of Medical Sciences, Isfahan, Iran. In this study, 193 people with acute coronary syndrome were selected based on convenience sampling method. Data were collected using demographic information-disease questionnaire and OCI-R (Obsessive-Compulsory Revised Inventory). Data were analyzed in SPSS version 18 using descriptive and inferential statistics. Findings: The mean score of obsessive-compulsive disorder was not statistically significant between acute coronary syndrome patients with and without cardiac symptoms (29. 64±, 20. 00 vs 26. 30±, 15. 74, respectively). The mean score of obsessive-compulsive disorder in washing subtype was statistically significant between acute coronary syndrome patients with and without cardiac symptoms (6. 82±, 4. 12 vs 3. 99±, 3. 48, respectively) (P<0. 05). Conclusion: Obsessive-compulsive disorder is not associated with cardiac symptoms in people with acute coronary syndrome except for washing subtype that the mean score of this subtype is more in acute coronary syndrome patients with cardiac symptoms than those without cardiac symptoms.

Aim: The present study aimed to investigate the effect of spousal support and companionship intervention on quality of life, marital intimacy and stress of cardiovascular patients. Background: Supportive care and attention to the psychological factors along with medical care in people with heart disease can help therapies to be more effective. Providing an appropriate emotional atmosphere in the family, along with attention to medical care such as medication and diet control, is one of the supports that people with heart disease can receive after coronary artery bypass graft surgery (CABG). Method: This study was a semi-experimental research which was based on multiple baseline single-case study. The sample included 2 married male patients who had CABG and their wives which were selected among those referred to cardiac rehabilitation centers of Yazd City, Iran. The participants received 8 sessions of spousal support and companionship intervention. The participants answered to the questionnaires quality of life,stress, anxiety and depression,and marital intimacy, before, during, at the end and one month after intervention. The data were analyzed using visual analysis, improvement percentage and reliable change index. Findings: Spousal support and companionship intervention increased the quality of life and decreased stress of patients, after intervention and in follow-up phases, but the patients’,marital intimacy did not change significantly after intervention. Conclusion: The quality of life and stress of patients may be improved if the wives appropriately support and accompany their husbands after CABG.

Aim: The aim of this study was to review the effect of music as a non-invasive, non-pharmacological, inexpensive method with no side effects, on people with heart disease Background. Heart disease is a common disease with considerable annual mortality. This review study investigates studies to bring a comprehensive view about the effect of music therapy on recovery of people with heart disease. Method: This study was a narrative review in which studies in Persian and English language were searched out in databases/ search engines Magiran, SID, IranMedex, Pubmed, Scopus, and Google Scholar using the keywords music therapy, heart failure, acute coronary syndrome, hypertension, hypertension, heart surgery and open heart surgery. Inclusion criteria included articles being published in Persian or English language that examined the effect of music on recovery of people with heart disease. There was no time limit for articles under review. Exclusion criteria included articles that their full text were not accessible. Findings: Out of 24 articles, the most of them (10 articles) examined the effect of music on hypertensive patients and on vital signs in heart patients (8 articles). The results showed that the effect of music on the recovery of heart patients included increasing the percentage of oxyhemoglobin saturation, relieving pain, reducing anxiety and depression, improving sleep quality and reducing fatigue. The music had no effect on mean arterial pressure and respiration. There were conflicting results regarding the effect of music on blood pressure and heart rate. Conclusion: Considering the easy and cost-free application of this method, it is recommended that the health care team and especially nurses use this non-invasive method in the care of people with heart disease.

Aim: This study was conducted to compare the effect of multidimensional spiritual therapy and stress inoculation training (SIT) on physiological and psychological coordination of heart rate variability (HRV) and depression in patients after coronary artery bypass graft (CABG) surgery. Background: Depression and other emotional disorders play an important role in reducing the physiological and psychological coordination of heart rate in patients after coronary artery bypass graft (CABG) surgery. Depression and other emotional disorders prevent the person from recovering from the pathologic condition. It seems that preparing the patient for proper coping techniques is helpful in improving emotional disorders and preventing recurrence of disease. Method: This was a clinical trial with two experimental and one control group. The study population included patients after CABG in Tehran Cardiac Research Center, Tehran, Iran. Thirty patients were randomly selected and assigned into three groups. The instrument of this study was the DASS-21 scale and the evaluation of physiological and psychological coordination of heart rate, which was measured before the intervention and at the end of the 10th session in groups. The first experimental group was exposed to the Meichenbaum stress inoculation training for 10 sessions of 90-minute duration, and the second experimental group received multidimensional spiritual therapy. Data were analyzed using Multivariate analysis of covariance in SPSS. Findings: Multivariate analysis of covariance showed that SIT and multidimensional spiritual therapy interventions both have a statistically significant effect in reducing depression in one-month and three-month follow-up, compared to the control group, but their effects on reducing depression was significantly different (-2. 200, P=0. 002). However, no statistically significant difference was observed between experimental groups in terms of changes in physiological and psychological coordination (-0. 00133, P=0. 1). Conclusion: SIT intervention seems to be less effective than multidimensional spiritual therapy in reducing depression, but its effect on changes in physiological and psychological coordination is the same as multidimensional spiritual therapy.

Aim: This study aimed to examine the effect of well-being therapy on hope, distress tolerance and death anxiety in people with cardiovascular disease after getting a coronavirus disease 2019 (COVID-19). Background: Cardiovascular patients rescued from COVID-19 face go through many psychological health issues regarding hope, distress tolerance and death anxiety. Well-being therapy has been known as one of the methods based on positive psychological approach that may have a positive effect on psychological health of these patients. Method: This study was a semi-experimental study with pretest-posttest design with control group. The statistical population was cardiovascular patients rescued from COVID-19 living in Ahvaz city, Iran, in year 2020, from which 40 people were recruited by convenience sampling method and randomly allocated two experimental and control group. The experimental group received well-being therapy for 10 sessions of 90 minutes duration (two sessions per week) and the control group was placed on the waiting list for training. Research tools were the hope scale, distress tolerance questionnaire and death anxiety scale. Data were analyzed in SPSS-19 using Chi-square test, independent t-test and multivariate analysis of covariance. Findings: The groups did not differ significantly in terms of gender, marital status, age, education and duration of illness. Also, before intervention, there was no statistically significant difference between the groups in terms of mean scores of hope, distress tolerance and death anxiety. After intervention, statistically significant difference was found between experimental and control group in the mean scores of all three dependent variables, meaning that well-being therapy improved hope (F=114. 497, P≤, 0. 0001) and distress tolerance (F=165. 032, P≤, 0. 0001), and decreased death anxiety (F=101. 408, P≤, 0. 0001) in people with cardiovascular disease after getting a COVID-19. Conclusion: Regarding the effect of well-being therapy on improving hope and distress tolerance and decreasing death anxiety people with cardiovascular disease after getting a COVID-19, it is recommended that therapists and health professionals apply well-being therapy to improve hope and distress tolerance and decrease death anxiety in people with cardiovascular disease after getting a COVID-19.

Aim: This study aimed to investigate the effect of telenursing on adherence to treatment in adolescents undergoing cardiac surgery. Background: Congenital Heart Disease (CHD) has a significant global prevalence and a large number of patients undergo cardiac surgery every year. Adherence to treatment is essential to achieve the expected outcomes of surgery. Method: This study was a quasi-experimental before-after study with control groups that was conducted in the year 2020. A total of 70 adolescents referred to a university cardiovascular medical and research center in Tehran, Iran, were recruited based on the inclusion criteria and then, randomly assigned to experimental (n=35) and control (n=35) group. The experimental group received a telenursing services via WhatsApp messenger for one month. Modanloo's questionnaire of adherence to treatment was used to collect the data. Data were analyzed in SPSS V-20 using descriptive and inferential statistics. Findings: There was no statistically significant difference between the experimental and control groups in terms of demographic variables. Before intervention, the mean score of adherence to treatment in the experimental and control groups was 71. 67±, 6. 97 and 71. 77±, 7. 89, respectively, which were not statistically different. After intervention, the mean score of adherence to treatment in the experimental and control group changed by 15. 17 and-2. 49, respectively, and the difference between the groups was found to be highly significant (P≤, 0. 0001). Conclusion: According to the findings, telenursing improved adherence to the treatment. Therefore, it is recommended to provide the ground to take the benefits of this approach through increasing public information and awareness and empowering the nursing staff.

Aim: This study was conducted to examine the effect of teach-back training on lifestyle of people with heart failure. Background: Lifestyle is a determining factor in the development and progression of cardiovascular disease, so the patient's adherence to therapeutic regimen (medication, diet, and physical activity) guarantees a healthy lifestyle. Method: This quasi-experimental study was conducted on 80 individual with heart failure who were admitted to the coronary care units (CCUs) and post coronary care units (PCCUs) of teaching hospitals affiliated to Zahedan University of Medical Sciences, Iran, in 2019. The patients were selected using the convenience sampling method and randomly placed into intervention and control groups. The tools used to collect the data included a demographic information form and Health-Promoting Lifestyle Profile II (HPLP II) questionnaire (HPLP2). The lifestyle questionnaire was completed by the participants in both groups in two stages, before and three months after the intervention. In the intervention group, lifestyle promotion training was performed individually using a teach-back method in 4 sessions, each lasting 30 to 60 minutes. Participants in control group received conventionally lifestyle promotion training. The data were analyzed using SPSS-22 software via the independent samples t-test, paired samples t-test, and chi-square test. Findings: There was no statistically significant difference between groups in terms of demographic characteristics. Before intervention, no statistically significant difference was found between the mean score of total lifestyle, in the intervention and control group (110. 82±, 48. 93 and 103. 38±, 37. 23, respectively). (P=0. 45). Three months after intervention, the mean score of total lifestyle in intervention group was significantly higher than that of control group (137. 80±, 54. 36 against 113. 23±, 37. 77) (p≤, 0. 0001). After intervention, the mean score of domains of lifestyle in the intervention group (except for interpersonal communication domain) were significantly higher than that of control group. Conclusion: The results of the present study showed that teach-back training promoted lifestyle and its domains (except for interpersonal communication domain) in people with heart failure. It is recommended that nurses use this training method to improve lifestyle in people with heart failure.

Aim: The aim of this study was to compare hope and anxiety between adolescents with a parent with chronic heart disease and adolescents with a parent with type 2 diabetes. Background. Chronic illness in parents is associated with developing problems such as decreased hope and anxiety for children. Method: The present study was a descriptive cross-sectional comparative study in which 120 adolescents either with a parent with chronic heart failure or with a parent with diabetes type 2 were recruited by convenience sampling. Schneider's hope scale and Beck anxiety questionnaire were used to collect the data. Data were analyzed using descriptive and inferential statistics in SPSS software version 24. Findings: The total hope score in adolescents with parents with chronic heart failure and adolescents with parents with type 2 diabetes was respectively 28. 70±, 5. 01 and 31. 40±, 4. 20. Sixty percent of adolescents with a parent with chronic heart disease had the lowest anxiety level, 25 percent experience mild anxiety, 10 percent reported moderate anxiety, and 5 percent experience severe anxiety. Ninety and five percent of adolescents with parents with diabetes showed the lowest anxiety, 3. 3 percent experienced mild anxiety and 1. 7 percent reported moderate anxiety. Conclusion: Adolescents with a parent with chronic heart disease have significantly higher levels of anxiety than adolescents with a parent with diabetes type 2, and there is a significant difference between their overall hope score. Because anxiety and hope can affect all aspects of a person's life, therefore, the implementation of educational and behavioral interventions to improve anxiety and hope is recommended.

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.

Aim: This study was conducted to examine the effect of self-management program on major advers cardiac complications of coronary angioplasty in patients referred to Tohid Hospital in Sanandaj, Iran, in 2018. Background: Coronary artery disease is the leading cause of death in people over 35 years of age in Iran. Coronary angioplasty is one of the most successful treatment techniques in people with coronary artery disease with some unwanted cardiac complications. Reducing these complications is one of the important goals of health care systems. Method: This was a quasi-experimental study that was conducted on 101 people with coronary artery disease undergoing angioplasty. The samples were selected by convenience sampling method based on inclusion criteria, and then randomly assigned to the experimental (n=51) and control (n=50) group. Data collection tools included a demographic information questionnaire and a checklist of coronary angioplasty complications. The intervention was implemented in sessions of 45 to 60 minutes duration three times per week in the presence of a family member and a copy was handed in. This intervention was continued for six months in the experimental group. During intervention period, the patient’, s condition and the implementation of the self-management program were followed up by phone. The control group received only routine care and the experimental group received both routine care and self-management program. Cardiac complications were assessed in the first, third and sixth months following intervention. Data were analyzed in SPSS version 21 using Chi-square, t-test and generalized estimation equations. Findings: The groups were homogenous in terms of age, gender, marital status, level of education, place of residence, employment status, body mass index, number of children, history of hyperlipidemia, history of diabetes, history of hypertension, history of alcohol consumption, history of heart attack, and type of artery involved. Generalized estimation equations showed that after intervention, the rate of complications of target vessel revascularization (P=0. 04), second coronary angioplasty, (P=0. 005) and coronary artery bypass graft surgery (P=0. 003) were significantly different between the control and experimental groups. However, there were no statistically significant difference between groups in terms of recurrent angina complications (P=0. 066), myocardial infarction (P=0. 069) and death (P=0. 019). Conclusion: The implementation of self-management program can reduce complications after coronary artery angioplasty. It is recommended for nurses to apply self-management programs and follow-up after discharge for this group of patients.

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.

Aim: This study aimed to examine the effects of pr eoper ative pr epar ation of patients and family car egivers on outcomes after coronary artery bypass graft surgery (CABG). Background: Pr eoper ative pr epar ation can impr ove 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 inter vention, the mean scor e 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: Consider ing that the pr epar ation of the patient and family car egiver on the day befor e 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.

Aim: The pr esent study was conducted to compar e the effect of high-intensity interval training (HIIT) and moderate-intensity continuous training (MIT) (with and without blood flow restriction) on quality of life in cardiotoxic women after breast cancer treatment. Background: Today, br east cancer is ver y common and car diotoxicity is one of the most impor tant non-avoidable complications after chemotherapy, which has a significant impact on patients’,quality of life. Using aerobic exercise training, with and without blood flow restriction, may improve quality of life of cancer survivors experiencing symptoms of cardiotoxicity. Restricting blood flow is already one of the methods used to enhance the effects of exercise training. On the other hand, previous studies show that different types of physical exercise have different physiological and psychological effects. Methods: In this r andomized clinical tr ial, 20 patients with cardiotoxicity after treatment for breast cancer were randomly divided into four groups including High-Intensity Interval Training (HIIT), Moderate Intensity Continuous Training (MIT), HIIT with Restricted Blood Flow (HIIT+BFR), and MIT with BFR (MIT+BFR). Interventions were applied for 12 weeks and three sessions per week. Patients in all groups completed the IHF-QoL quality of life questionnaire before and after 12 weeks of intervention. Findings: The r esults of the pr esent study showed that HIIT as well as the aer obic exer cise with limited blood flow affects the quality of life of cardiotoxic patients. Quality of life scores in the HIIT+BFR group was significantly higher than that of the other groups. According to the scoring method in the questionnaire, increasing the individual score in each of the four areas of the questionnaire indicates a decrease in symptoms that disrupt the quality of life. Conclusion: It seems that HIIT with BFR is a better way to deal with the symptoms that disr upt the quality of life, compared to HIIT without BFR, and also MIT (with and without restricting blood flow).

Aim: This study was conducted to assess family follow-up for children with implantable defibrillators and the role of nurse in patient/ family education Background: Implantable defibrillators are devices with the capability of rhythm detection and antiarrhythmia therapy. The proper functioning of these devices highly depends on regular interrogation, analysis, and programming. Method: This descr iptive compar ative study was conducted based on the hospital information system )HIS( of Rajaie Cardiovascular Medical and Research Center. All children under 15 years of age, for whom the defibrillator device had been implanted or followed by the first author, from 2009 to 2020, were included. Continuation of follow-up was compared according to age, gender, underlying disease, area of residence, and type of family education. Data were analyzed in SPSS-24 using descriptive and inferential statistics. Findings: Sixty-seven implantations had been done for 61 patients. The mean and standard deviation of patients’,age was 9. 58±, 3. 72 years )aged 1 to 15 years(. The rate of follow-up continuation was significantly reduced during the follow-up period. Ninety-four percent of patients had been visited for the first postimplantation appointment,this rate decreased to 43. 6 percent for the 5th year post-implantation visit )p≤, 0. 0001(. Follow-up continuation was 71. 13 percent with old-type family education compared to 89. 64 percent with the new-type one )p=0. 002(. Conclusion: Consider ing the high-risk situation, follow-up continuing is less than those desired for children with defibrillator devices. Family education by interactive methods plays an important role in encouraging the families to regular follow-up.

Aim: This review study aimed to investigate the r ole 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 car e 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 sear ching out Persian and English databases of Magir an, 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 pr esent study showed that toler ating the thir st for mor e 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.

Aim: The aim of this review study was to explain the consequences of pr e-hospital delay in patients with acute myocardial infarction. Background: Studies have shown that patients with acute myocardial infarction who refer to medical centers late, experience adverse mechanical and electrical consequences of acute myocardial infarction. Method: In this review study, the keywords Outcome, Myocardial infarction, Delay, and Survival were used to search out the relevant papers published between 2000 and 2020, in databases, Up-to-date, Scopus, PubMed, Science Direct, Web of Science, SID, and Magiran. A total of 14 articles were reviewed. Findings: The review of the articles showed the consequences of pr e-hospital delay in patients with acute myocardial infarction as the following: acute heart failure, cardiac arrest, stroke, mortality, decreased cardiac ejection fraction, long-term hospitalization, decreased long-term survival, increased in-hospital mortality, and increased treatment costs. Conclusion: Pre-hospital delay in patients with acute myocardial infarction is associated with complications and adverse consequences for patients. Health care team should educate patients and their families about the signs and symptoms of cardiovascular disease and the importance of timely treatment.

Aim: This Study aimed to examine the effect of social networking education on blood glucose control and post-surgical infections after open heart surgery in diabetic patients. Background: Cardiovascular surgery is one of the most common surgeries that is per for med with the aim of increasing survival and improving the quality of life in diabetic patients. Method: This randomized clinical trial study was conducted on 120 diabetic patients (age range 18-60 years) who underwent open heart surgery at Shahid Rajaei Cardiovascular Research and Research Center. The participants were randomly divided into experimental (n=60) and control group (n=60). In the experimental group, posts were delivered to patients with educational content (such as nutrition education, blood sugar self-monitoring, and. . . ) on a daily basis for three months on the WhatsApp social network. Data were collected by a checklist consisting of three parts: demographic characteristics, fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c) of patients before and 3 months after the intervention. Findings: In both experimental and control group, 55 percent were male and 45 percent were female. The percent of patients with postoperative wound infection in the experimental and control groups was 5. 0 and 3. 3, respectively. After intervention, in the experimental group, the FBS and Hb1Ac median was significantly reduced compared to before the intervention (p<0. 001). The levels of FBS and Hb1Ac before and after the intervention did not differ significantly between the experimental and control group. Conclusion: There was no different between groups in terms of blood sugar control and wound infections after open heart surgery. Due to the easy access, lack of time and space limitations of using social networks, further studies with longer follow-up are recommended.

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 hear t 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.

Aim: The aim of this study was to review studies that investigate the factor s affecting adherence to treatment in people with cardiovascular disease. Background: Adherence to treatment is a comprehensive term that is used to convey acceptance of treatment process and following professional advice by the patient to increase the quality of life. Given the importance of adhering to treatment plans and being aware that many people do not follow treatment plans, understanding the factors that lead to patients' effective adherence to the treatment regimen can lead to the development of strategies to increase patients' adherence to the therapeutic regimen. Method: Articles published between year s 2010-2020 were searched out in databases Science Direct, PubMed, Cochrane, Medline, SID, Scopus, CINAHL, OVID, Iran Doc and Magiran using the keywords adherence to treatment, cardiovascular diseases and their Persian Equivalents. Research articles in Persian and English focusing on the factors affecting the adherence to treatment in cardiovascular patients were selected for the study. In total, 167 articles were found in primary search by reviewing the title and abstract and in some cases after studying the full text of the articles,out of them, 11 were selected that were in accordance with the research purpose of this study. Findings: The most effective methods for improving adherence to treatment were tele-nursing and educating colleagues on how to follow up patients. Also, recognizing differences between personal and psychological aspects of patients and adopting an appropriate method for each person to pursue treatment and increase adherence to the treatment regimen are very important known factors in the care of cardiovascular patients. Conclusion: In general, the car e and training provided and continuous follow-up by the health care professionals have the greatest impact on increasing adherence to the treatment regimen among patients.

Aim: This review discusses the exercise training that appear to be effective in cardiovascular patients with Covid-19. Background: Nowadays, cardiovascular diseases are the pivotal leading causes of death in the world. Given the change of the human lifestyle into a sedentary one, the number of people with cardiovascular disease is rising dramatically. Recently, Covid-19 disease has endangered people's health in many countries and put a lot of pressure on their health care system. It also has had a significant impact on the global economy. The main features of this disease are high transmission rates and mortality. Although the prime cause of death from Covid-19 is respiratory failure, some patients experience severe cardiovascular problems such as congestive heart failure. Although drugs and therapeutic interventions have improved considerably, it is still challenges in prevention and rehabilitation for these diseases, especially in people with Covid-19, and the search for new strategies continues. Cardiac rehabilitation is a set of medical procedures and exercise training that aim to improve the mental status, physical function and overall increase the quality of life. One of the most important parts of cardiac rehabilitation is prescribing exercise. Method: The keywords "Cardiovascular disease", "Covid-19", "Rehabilitation", and "Exercise training" were searched out in databases, Science Direct, PubMed, Cochrane, Medline, CINAHL, SID, Iran Doc, and Magiran. Out of articles, 210 articles that were more relevant to the research topic were selected. After reviewing the studies thoroughly, 12 studies that were in line with the purpose of the study were selected and reviewed. Findings: Exercise training prescribed for cardiovascular patients has prescribed over the years ranges from prescribing one type of exercise for all to prescribing exercise for each patient individually based on risk factors, age, and functional status. Continuous aerobic exercise, periodic aerobic exercise, and strength training have been used in most studies. Less intensity should be used when prescribing these exercises to cardiovascular patients with Covid-19. Conclusion: In general, considering the beneficial effects of rehabilitation training in cardiovascular patients, it seems that a rehabilitation program based on appropriate exercise training can be effective in reducing the complications and mortality of cardiovascular patients with Covid-19. But more studies are needed to get more information.

Aim: This study was conducted to examine the effect of using Bur n weaning checklist on the duration of mechanical ventilation and hemodynamic criteria in patients undergoing adult open heart surgery. Background: Mechanical ventilation is an adjunct or alter native to spontaneous br eathing. Due to the proximity of the circulatory and pulmonary systems, the balance of the mechanical ventilation system and the human cardiovascular system is complex, and its weaning must be planned. Method: This r andomized clinical tr ial study was per for med on 80 patients admitted for open heart cardiopulmonary bypass surgery. After random assignment, in the control group, the weaning process was performed according to the routines by a physician, and in the experimental group, the weaning was performed by a Burn checklist by a physician and a nurse. Hemodynamic criteria )first and second hours upon arrival, first and second hours during weaning, first and second hours after weaning( and duration of mechanical ventilation were recorded and compared between experimental and control group. Data were analyzed in SPSS software version 22 using two-way repeated measures ANOVA. Findings: The mean intubation dur ation in the exper imental group )7. 50±, 1. 86 hours( was significantly less than the control group )11. 30±, 3. 39 hours( )P≤, 0. 0001(. The interaction between group and time for variables diastolic blood pressure )P=0. 002(, pulse pressure )P=0. 003( and heart rate )P≤, 0. 0001( was statistically significant. Conclusion: The use of the Bur n assessment checklist r educes the duration of weaning process in patients after adult open heart surgery. It also helps balancing hemodynamic criteria.