Cardiovascular Nursing Journal
Year:2014 | Volume:3 | Issue:2|Papers Count:8

Background: One of the most important aspects of care and follow-up after coronary artery bypass graft surgery is treatment adherence program. As the long term success of the surgery depends on the treatment of adherence plan.Aim:The purpose of this study was to evaluate the efficacy of phone and SMS follow-up care on patients'' treatment adherence after coronary artery bypass graft.Method: This clinical trial was performed on patients undergoing coronary artery bypass graft surgery in the heart surgery unit in Tehran hospitals in 2014. In this study, 90 patients were selected purposively and allocated into telephone follow-up group (n=30), SMS follow-up group (n=30) and control group (n=30). Demographic and treatment adherence questionnaire were completed twice (before intervention and two months after the intervention). The telephone follow-up and SMS follow-up groups were given training and booklet before discharge. In telephone follow-up intervention, three calls a week was made for two months and the SMS follow-up group received text messages daily for two months. To analyze the data, Chi-square test, Fisher exact test, t-test and ANOVA, ANCOVA, and Bonferroni test were used.Findings:There was no statistically significant difference between the telephone follow-up and SMS follow-up groups in terms of treatment adherence scores, before and after intervention. A statistically significant difference was seen between telephone follow-up and control groups (p<0.0001), and SMS follow-up and control groups (p<0.0001) in terms of treatment adherence scores, before and after the intervention. .Conclusion: Both SMS and telephone follow-up are effective to improve treatment adherence in patients after coronary artery bypass graft. It is suggested to use these interventions for patient following coronary artery bypass graft.

Aim: This study assessed the knowledge of nurses about arterial blood gases interpretation in intensive care units of selected hospitals in Tehran.Background: Measurement of arterial blood gases are widely used in intensive care units. The knowledge and mastery in interpretation of arterial blood gases is an essential skill for critical care nurses.Method: This descriptive-analytical study was conducted on 117 nurses working in intensive care units at selected military hospitals in Tehran in 2013. Data were collected using a questionnaire consisted of 45 questions about personal and professional information, also in the domain of blood gases interpretation based on Bloom''s classification of knowledge (judgment and evaluation phase). Data are analyzed by SPSS and descriptive and inferential statistics were presented.Findings: Knowledge of intensive care unit (ICU) nurses was moderate to poor in arterial blood gas interpretation. A statistically significant difference was seen between the knowledge of the subjects in terms of some variables. Conclusion. Given the importance of arterial blood gases interpretation in ICUs, it is necessary to pay attention to in-service and continuing education programs for nurses.

Aim: The study was conducted to examine the effect of passive range of motion exercises on motor function of patients in acute phase of stroke.Background: Stroke is one of the most common cerebrovascular disorders. Continuous repetitive exercises in the first six month of stroke may restore significant part of sensory-motor function.Method: In a randomized controlled trial, the patients with moderate or sever ischemic stroke who experienced hemiparesis or hemiplegia were recruited. Motor function level of defected limb was assessed based on “modified ashworth scale” and motor strength scoring tool. Patients in experimental group (n=37) received passive range of motion exercises, within the 48h of onset of stroke, 6-8 times with 30-45 minutes duration. Patients in control group (n=24) received conventional care. The groups were compared one month after interventionFindings: The most recovery was found in upper extremity strength after first month (3.45) relative to basic assessment (2.36). In experimental group, motor strength of upper and lower extremity improved, one month after intervention (P<0.0001). The results showed recovery in motor strength just in upper extremity of control group, after one month (P=0.012). Intervention had no effect on muscle tone.Conclusion: According to more positive changes in motor function of experimental group after one month, it is suggested to apply the intervention for this group of patients.

Aim: This study aimed to examine the effect of music intervention on anxiety in patients with heart failure.Background: Anxiety as a psychological problem can increase heart rate, respiration rate and blood pressure all of which have an advert effect on heart in patients with cardiovascular disease, particularly patients with heart failure.Method: This controlled clinical trial study was conducted in Doctor Shariati Hospital affiliated to Tehran University of Medical Sciences. In this study, in each group (control, and music intervention), 25 hospitalized patients with heart failure were recruited through convenience sampling. Then, patients were allocated to groups by simple randomization. Data were collected by demographic characteristic form and Spiel Berger anxiety assessment questionnaire. In music group, music including two of the three types of classical, gentle and Iranian traditional music was played for 20 minutes after meeting for 3 sequential days by a tape recorder and headphone. Before and 15 minutes after intervention, patients'' anxiety was measured and compared. Data was analyzed by using independent t-test, Paired t-test, Fisher’s exact test through SPSS.Findings: There was a statistically significant difference between control and music intervention groups regarding anxiety score. Also, there was a statistically significant difference, before and after music intervention in anxiety score of patients with heart failure (p<0.0001).Conclusion: The findings indicated that music intervention significantly reduces anxiety in patients with heart failure. Because of the importance of anxiety reduction in patients with heart failure, it is proposed that music intervention be used in the care of these patients.

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.

Aim. The purpose of this study was to examine the effect of white noise on the anxiety of patients in theCardiac Care Unit (CCU).Background. Many patients with cardiovascular disease suffer from some degree of anxiety after admission to CCU. Anxiety adversely affects patients' recovery.Method. This was a quasi-experimental study conducted in Shaheed Rajaei Cardiovascular Center, Tehranin 2014. Ninety patients admitted to the cardiac care unit were recruited in the study based on conveniencesampling and divided into experimental and control group (45 patients in each group). Anxiety was measured in both groups for 2 consecutive days by DASS-21 questionnaire. In the experimental group, whitenoise with an intensity of 50 to 60 decibels was played for 30 minutes. Data were analyzed by SPSS, version 17, using independent t-test, paired t-test and chi-square test.Findings. In control group, the difference between mean scores of anxiety, before and after interventionwas not statistically significant (5.17±3.90 and 4.73±3.77, respectively; p=0.08). In the experimental group, the difference between mean scores of anxiety, before and after intervention was statistically significant.(5.38±3.87 and 4.58±3.71, respectively; p=0.01).Conclusion. The white noise can reduce the anxiety of patients admitted to CCU. This method can be usedas a simple and low-cost non-pharmacological intervention for these patients.

Aim:The purpose of this paper is to review pathophysiology and prevention of presser ulcer in cardiac surgery.Background: Decubitus ulcer is a one of the important issues of health care, national patient safety index and quality of health care.Decubitus ulcer as complication of hospitalization affects patients'' health negatively, increases the costs of hospitalization and takes personnel time, especially in CABG patients.Method: The data bases Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, Medline, Embase and PsycINFO were searched for by the key words «Prevention», «Bed sore» «CABG»،« Decubitus ulcer» and «Control», alone or with their Persian equivalents.Findings: The main cause of decubitus ulcer in patients after CABG consists of tensile forces, friction, moisture, malnutrition, anemia, infection, fever, obesity, excessive weight, age and impaired peripheral circulation. The most important preventive ways are identifying individuals at risk using standard pre-operative evaluation, regularly observing and keeping the skin clean, changing the position of the patient every two hours, using pressure distribution devices such as wind and water mattresses, and foam equipment such as coatings containing gel on the at risk areas.Conclusion: The risk of decubitus ulcer after CABG can be reduced by preventive strategies.

Aim:This review study was done with the purpose of exploring the role of diabetes role in the development of atherosclerosis.Background: The process of accumulation of fat in the blood vessels is called atherosclerosis. The most important risk factors and aggravating condition of atherosclerosis are the accumulation of carbohydrates and diabetes.Method: In this study, we reviewed the electronic and manual searches of databases such as Medline, Embase, Springer, Blackwell Synergy, Elsevier, Scopus, Cochran Library and the databases SID, Iran Medex and Magiran within the time period of 2005-2015.Findings:The most common cause of death in patients with diabetes is coronary artery disease. Because nitric oxide production is higher in diabetic patients, the process of atherosclerosis occurs more rapidly and coagulation cascade disorder leads to the platelet adhesion, so, diabetic people, especially women, are more prone to atherosclerosis and coronary artery disease.Conclusion: Nurses can modify several risk factors for atherosclerosis in these patients through education and follow-up, thereby, improving quality of life in these patients.