atefeh allahbakhshian

Patients with coronary artery disease (CAD) can improve quality of life by undergoing coronary artery bypass graft (CABG), but they may face various complications. Early mobilization can help prevent these complications. This study aimed to evaluate the effects of two early mobilization protocols on pain and hemodynamic outcomes in patients who had CABG surgery.

This was a randomized, blinded clinical trial with a three-arm parallel design, conducted on 105 patients who underwent CABG at Shahid Madani hospital in Tabriz. The patients were randomly assigned to three groups: control, first intervention, and second intervention. The control group received standard care, while two intervention groups received early mobilization based on passive and active range of motion (ROM) activities and early mobilization based on deep breathing exercises respectively. Data were collected using a questionnaire that measured pain intensity using a facial pain scale and hemodynamic indicators using a monitor device. Data analysis was performed using SPSS version 24 software and descriptive and inferential statistics methods.

According to the study, the second intervention group is more effective than the first intervention group. The results indicated that in both morning and evening shifts, the mean of systolic blood pressure (SBP) increased significantly in three groups. Also, the mean of diastolic blood pressure (DBP) increased significantly in both shifts in intervention group 1 and control. The mean of DBP decreased (MD=-26.0, 95% CI: -5.6 to -1.2; P=0.003) significantly among intervention group 2 compared to control group in the evening. The results also indicated that the mean of heart rate (HR) raised significantly in both shifts in all three groups. In the morning, there was a significant difference between intervention group 2 and 1 compared to control. The mean of arterial oxygen saturation was a significant difference between intervention group 2 and intervention group 1 and control group in the both shifts. The mean of pain decreased significantly in the morning in two intervention groups. Similarly, in the evening, the mean of pain decreased significantly in intervention group 1, and intervention group 2. Both in the morning and evening, there was a significant difference between intervention group 2 and intervention group 1 (P<0.001).

This study provides valuable insights into the effects of early mobilization interventions on patients after CABG, but more research is needed to determine the optimal timing and intensity of mobilization protocols for patients after CABG and to explore the long-term effects and cost-effectiveness of these interventions.

Cardiovascular disease is the leading cause of death worldwide as well as in Iran. These patients have a wide range of sexual problems. The purpose of this study was to determine the state of sex function in patients with coronary artery disease.

In a descriptive correlation study, sexual function among patients with coronary artery disease were examined in 253 patients. The data were collected at the Tabriz Shahid Madani Hospital cardiac clinic during the first six months of 1397. Participants were involved with the study using the convenience sampling method. Demographic and treatment-related data with a demographic questionnaire and sexual function data in men and women with standard male sexual function questionnaire (MSHQ-Men Sexual Health Questionnaire) and standard questionnaire of female sexual function index (FSFI-Female Sexual Function Index), respectively, were collected by interview. The data were analyzed using SPSS version 22.

In this study, out of a total of 253 patients, 54.5% were men and the remaining were women and the average age was 51.99±6.65. According to the male sexual function survey, the total sexual function score was 53.46 ±90 out of 80. The rating of the ejaculation dimension was superior to other dimensions. The overall score for the female sexual function was 24.42 ±4.43 out of 36. Women reported the highest score for sexual pain (5.55±.57) and the lowest score for sexual desire (2.83± 1.09). The total score on the questionnaire indicated that 74.4 women had a poor sexual function. Among all women, 27% had no sexual function during the last month. Sexual function was also significantly associated with certain demographic and pathological characteristics such as age, level of education, economic status, Ejection fraction, length of illness, and history of infarction.

Sexual function in these patients, particularly in women, is severely affected. Health care providers should be more attention to the sexual problems of these patients.

Poor medication adherence (MA) is a significant concern in patients with cardiovascular disease (CVD) in low and middle-income countries. Thus, understanding the factors affecting this concern is the first step in designing effective interventions in such societies. In this regard, the purpose of this study was to investigate MA in a sample of Iranian patients after coronary angioplasty and to identify prediction factors based on the World Health Organization framework.

This descriptive-correlational research was conducted on 203 patients post carotid artery (CA) who were recruited from the Cardiology Clinics of Tabriz between November 2016 and February 2017. Data were collected based on socio-demographic characteristics and the Persian version of the Morisky Medication Adherence Scale (MMAS), and the Charlson comorbidity index was used as well. Finally, the multiple linear regression method was applied to identify the significant predictors of MA.

The mean (standard deviation) MMAS score was 5.85 (±1.83). A multivariable model (adjusted R2=0.136) predicted adherence using experienced medication side effects (B=-1.094, a 95% confidence interval (CI)= -1.700– -0.489, P<0.001) and having a recall (B=0.658, 95% of CI=0.153-1.163, P=0.011) and hospitalized history due to current disease (B=-0.537, 95% of CI=-1.031–-0.043, P=0.033).

The results of this study provide a better conception of the role of patients’ experiences about medication side effects and the presence of a recall member in the family for MA after angioplasty. Patients’ problems and concerns related to the side effects of medications must be resolved to improve MA.

There are some side effects such as the restenosis of the coronary artery resulted from the failure to follow the medication regimen. Considering that patients" beliefs have a great role in their lifestyle, this study aimed at investigating the relationship between beliefs in medication and self-reported medication adherence in patients with coronary angioplasty (CA).

This was a descriptive cross-sectional correlational study. Based on the inclusion criteria, qualified participants were chosen from among the patients who referred to heart specialty hospital using a convenience sampling method. The applied questionnaire in this study included three sections encompassing the demographic information, a 5-item Medication Adherence Questionnaire (MARS), and BMQ-S questionnaire containing two aspects of "necessity" and "concerns about taking medications".

The mean of participants" age was 56.99 (SD=12.80) and the majority of the participants were males (78.7%), married (89.3%), and mostly illiterate (30.7%). The study results showed that 70% (n=105) of the participants had a weak medication adherence. The results of the Pearson correlation demonstrated a statistically significant relationship between the beliefs in medication and adherence to it.

After CA, nurses and family members can pave the way for the patients to adhere to medication by influencing their beliefs

The proper levels of critical thinking (CT) and professional self-concept (PSC) both have key roles in the academic achievements of nursing students. The present study was conducted to examine a possible correlation between PSC and CT.

This descriptive-correlational study was conducted on 154 eligible nursing students, selected through the stratified random sampling technique. For this purpose, two instruments were utilized: the Persian version of nurses’ self-concept questionnaire and Ricketts’ Critical Thinking Disposition Assessment Scale. Pearson’s correlation coefficient was employed to analyze data using SPSS 16.

Although levels of CT vary in different semesters, the correlation coefficient between CT and PSC among nursing students was -0.46 (P<0.001). Therefore, there was a significant, inverse, moderate correlation between these two variables.

The correlation between the total scores of PSC and CT was significant and negative, indicating increasing professional self-concept in students decreases their levels of CT. It seems that modern teaching methods based on problem-solving are less used in nursing students’ education, which leads to greater development of CT. It is believed that other underlying factors may have contributed to the negative correlation between PSC and CT. Further studies in this regard are recommended.

Investigation of supportive care needs of cancer patients is important to implement any supportive care programs. There is no relevant studies investigated supportive care needs of Iranian cancer patients and factors affecting such needs. So, the aims of present study were to determine the unmet supportive care needs of Iranian cancer patients and its predictive factors.
In this descriptive- correlational study 274 cancer patients in one referral medical center in North West of Iran participated. For data collection, demographic and cancer related information checklist and Supportive Care Needs Survey (SCNS) was used. Logistic regression was used for data analysis of un-adjusted and adjusted Odds Ratios (ORs) for patients needs and analysis of variables of study based on Backward LR procedure SPSS Ver.13.
More than fifty percent of participants reported unmet needs in 18 items of SCNS. Most frequent unmet needs were related to health system and information domains and most meet needs were related to sexuality and psychological domains. The result of logistic regression identified predictors of each domain of supportive care needs. The variable such as sex, age and living situation were most important predictors of unmet needs.
The results showed that Iranian cancer patients have many supportive care needs in different domains. In general female cancer patients are at risk of more unmet supportive care needs. So, health care professionals should be more sensitive to fulfillment of supportive care needs of female.

The aim of this study is to clarify the perception and experience of life in Iranian patients after angioplasty. Regarding the high prevalence of coronary artery disease and increasing number of patients in Iran، and widespread use of medical procedures such as angioplasty for the treatment and due to multiple challenges during the post-treatment which affect different dimensions of lives of patients، an in-depth understanding of the experiences of patients plays a significant role in improving the quality of their lives. Qualitative approach with content analysis method was used to conduct the study. Purposeful sampling was used to recruit 20 patients who had experienced angioplasty. Data were collected through semi-structured interviews. The interviews were analyzed using qualitative content analysis method. During the process of data analysis، four themes reflected the experience and dimensions of life in patients after angioplasty، which included “rebirth، another opportunity”، “revising lifestyle”، “deciding to modify lifestyle” and “the use of available social support resources”. The results of this study will enhance our understanding of patients'' experiences and this، in turn، can guide health care system to support patient care and planning to promote care and unique counseling programs along with understanding of the real needs of the patients.

Complications after gastrectomy have an important effect on all dimensions of quality of life in patients with gastric cancer. The purpose of this study was to define the effect of educating self-care program on the quality of life in patients with gastric cancer after gastrectomy in Tabriz Hospitals. Fifty four patients with gastric cancer undergoing gastrectomy were studied in two groups: experimental and control. Data were collected using three questionnaires: demographic, quality of life in patients with cancer, and quality of life in patients with gastric cancer. Experimental group was educated about self-care program face to face for 30 minutes. The quality of life in patients with gastrostomy in both groups before surgery and one month after discharge was assessed. Before and after educating self-care program, the overall quality of life based on QLQ-C30 questionnaire in experimental and control groups was not statistically significant, but in experimental group significant differences were observed in global quality of life (P=0.04), emotional function (P=0.004), and physical problems (P=0.03). The overall quality of life based on QLQ-STO22 questionnaire before and after the educating self-care program in control group was not significantly different, but in experimental group significant differences were observed (P=0.04). Also in this group, some dimensions such as dysphagia (P=0.01), stomachache (P=0.001) and emotional problem (P=0.04) the quality of life improved. The mean difference was not significant in overall QOL between two groups, before and after intervention. However, differences were significant in the emotional (P=0.006) and psychological dimension (P=0.007). Education of self-care program after gastrectomy was effective on improving overall QLQ based on QLQ-STO22 questionnaire in test group and also was effective in improving some dimensions of quality of life such as psychological, emotional and global QLQ and effective on reducing physical and eating problems.