فصلنامه پرستاری قلب و عروق
سال پنجم شماره 1 (پیاپی 17، بهار 1395)

Aim. This study aimed to determine predictive power of obesity indices, cardiovascular fitness and physical activity in the development of cardiovascular disease (CVD) in male and female college students.
Background. Given the high mortality due to cardiovascular diseases from the young age caused by obesity and physical inactivity, the primary prevention, especially at an early age can be a solution to avoid the disease. Initial screening by simple, secure and affordable methods for prevention is essential.
Method. A total of 223 students (150 males, age 20.33±1.71 and 73 females, age 20.36±1.72) participated in this cross-sectional descriptive study. Data were obtained using a questionnaire, anthropometric measurements, and cardiovascular fitness (VO2max). Independent t-tests was used to show difference between gender in terms of variables, ANOVA was used to determine the differences among groups of male and female separately, whose had the different number of risk factors, and Pearson and Spearman correlation coefficient were used to determine the correlation of obesity indices and VO2max with metabolic risk factors, and the ROC curves was used to measure the power of predicting and the cut-off points of cardiovascular risk factors.
Findings.Statistically significant correlation was found between obesity indices and metabolic risk factors (other than blood glucose and systolic blood pressure in males). As the number of metabolic risk factors increased, elevation in obesity indices in females and the reduction of VO2max in males were significant. All obesity indices were within normal range. Cut-off points calculated by the ROC were 21.11 for body mass index and 75.15, 0.44 and 75.50, 0.47 for waist circumference and the waist-to-height ratio, for males and females respectively.
Conclusion. The findings of this study showed that the obesity indices are more powerful than physical activity levels and VO2max for predicting the possibility of cardiovascular disease among students.

Aim.The aim of this study was to determine nurses’ knowledge, attitude, and performance in cardiopulmonary resuscitation (CPR) based on PRECEDE model.
Background. Despite development of CPR team in Iran’s hospitals, performance in the field of CPR is not satisfactory.
Method. In this cross-sectional descriptive analytical study, all staff nurses (n= 97) working at ateaching hospital (9 Day) in Torbat-e-Heiydariyeh, Iran, were studied.The data collection tools included a reliable and valid researcher-made questionnaire to collect demographic data and a questionnaire which developed based on PRECEDE model.Data were analyzed in SPSS version 20 using ANOVA, linear regression and Pearson correlation coefficient.
Findings. The mean age of the nurses was 29.45±7.45 years.The average score for PRECEDE model constructs were 79.17±18.68 (knowledge), 95.48±6.64 (attitude), 62.6±19.52 (enabling factors), 67.61±20.12 (reinforcing factors), and 72.37± 9.71 (performance).Also enabling factors were the most important predictor of nurses’ performance (B=0.773, pConclusions. Constructs of knowledge, attitude, and performance were in desirable level and constructs of reinforcing and enabling factors were in moderate level. It is recommended to implement interventions and programs while considering enabling and reinforcing factors for promoting the performance of nurses in CPR.

Aim.The present study aimed to examine the relationship of perfectionism with procrastination and coping styles in people with coronary heart diseases (CHD), compared with healthy controls.
Background. Psychological factors may increase the risk of CHD by influencing physiological risk factors. Although psychological factors play an important role in development of CHD, more research in this area is necessary.
Method. In this descriptive correlational study, 218 male people (107 people with CHD as case group, and 111 people without CHD as their controls) were selected by convenience sampling. Data were collected by Mann’s Decisional Procrastination Scale, Lay’s Behavioral Procrastination Scale, coping styles Scale by Endler and Parker and Tehran Multidimensional Perfectionism Scale. Pearson correlation coefficient and linear regression were used for data analysis.
Findings.According to the findings, other-oriented perfectionism was directly associated with behavioral and decisional procrastination in case group, while in the control group, other-oriented perfectionism was negatively associated with decisional procrastination, however, the association was not significant. The effect of other-oriented perfectionism on decisional procrastination was significant in both groups. In case group, other-oriented perfectionism had a significant effect on behavioral procrastination, however other-oriented perfectionism had a significant effect on problem solving style in control group.
Conclusion.Other-oriented perfectionism had positive, but not strong relationship with both aspects of procrastinations in case group. In regression models of different aspects of perfectionism on procrastination, only the effect of other-oriented perfectionism was significant. Although the regressions were significant, fitted models had low predictive power. Only the other-oriented perfectionism could somewhat predict behavioral and decisional procrastination.

Aim. This study aimed to compare the effects of Swedish massage and preferredmusic intervention on anxiety in patients with chronic heart failure.
Background. Anxiety can affect the comfort and health of patients.One of the goals of nursing care is providing comfort for patients. Use of complementary therapies including Swedish massage and preferred music can be effective in improving anxiety.
Method. This quasi-experimental study with pre-test post-test design with control group was conducted in Doctor Shariati Hospital of Tehran University of Medical Sciences. In this study, in each group (control, Swedish massage and music intervention), 30 hospitalized patients with chronic heart failure were recruitedthrough convenience sampling. Then, patients were allocated to groups by simple randomization. Data were collected by Spielberger anxiety assessment questionnaire. Swedish massage was conducted daily for 20 minutes at evening for three consecutive days by using almond oil. In music group, patient’'s preferred music including two of the three types of classical, gentle and Iranian traditional music was played for 20 minutes at evening for 3 sequential days by a tape recorder and headphone. Before and 15 minutes after intervention, patient's anxiety was measured and compared. Data were analyzed in SPSS version 21 using ANOVA, Paired t test, Fisher’s exact test.
Findings. The results showed that patient's preferred music and Swedish massage significantly reduced anxiety in patients with chronic heart failure, although Swedish massage reduced anxiety of patient's with chronic heart failure more than music intervention (pConclusion. The findings indicated that patients who received Swedish massage experienced lower levels of anxiety. Regarding the importance of anxiety control in patients with heart disease, it is proposed that Swedish massage can be used in the care of these patients and it is preferred to the music intervention.

Aim. This study aimed to examine the effect of application of Braden pressure ulcers risk assessment tool on performance of critical care nurses.
Background. Pressure ulcer is a common phenomenon in patients admitted to intensive care unit. The management of pressure ulcers in these patients is a challenging task. Therefore¡ pressure ulcer prediction tools are used when dealing with these patients.
Method. This quasi-experimental study was conducted in the intensive care units. The study sample consisted 68 critical care nurses working inintensive care units of selected hospitals of Tehran University of Medical Sciences in 2013. After determining the sample size and obtaining permission from theethics committee of Tehran University of Medical Sciences¡ the participants were recruited through convenience sampling based on inclusion criteria. Critical care nurses of two intensive care units of general hospitals of Tehran University of Medical Sciences were selected as experimental and control group. In both groups¡ after collecting demographic characteristics¡ their performance in the management of patients who were at risk for pressure ulcers was evaluated by the checklist whose validity and reliability was evaluated by the faculty members of Tehran University of Medical Sciences. The data were analyzed by descriptive and inferential statistics in SPSS version 19.
Findings. There was no statistically significant difference between the groups in terms of demographic characteristics. After the intervention¡ the mean score of nurses performance in the experimental group was 66.21±0.47 and that of control group was 62.59±1.31 (p≤0.0001). After intervention¡ all nurses in the experimental group had very good performance and nurses in the control group had good performance.
Conclusion. Using the pressure ulcers risk assessment tool (Braden scale) increases the sensitivity of critical care nurses to the risk of ulceration in the intensive care unit patients and forces them to comply with the standard caring measures and consequently¡ lead to prevention of bed sores. It is recommended to use this tool in order to enhance the care management of patients prone to pressure sore.

Aim. This study aimed to examine the effect of damask rose on sleep quality of patients undergoing angiography admitted to cardiac care unit.
Background. Sleep is one of the basic human needs and determine the health and recovery. Most patients hospitalized in cardiac care unit experience some degrees of sleep disorder.
Method. In this double-blind clinical trial¡ 90 patients were randomly allocated to experimental (n=45) and control (n=45) group. Data collection instrument consisted of demographic data and St. Mary''s Hospital Sleep Questionnaire (SMHSQ). In experimental group¡ damask rose extract was given by oral route¡ 15 drops every 8 hours. The patients in control group received placebo by oral route¡ 15 drops every 8 hours. Data were collected¡ before and after intervention and were analyzed in SPSS 16 using descriptive and inferential statistic.
Findings. Both groups were homogeneous in terms of demographic characteristics. There was no statistically significant between groups in terms of sleep quality¡ but¡ a statistically significant difference was found between sleep quality¡ before and after intervention¡ in each group.
Conclusion. A significant difference before and after treatment in both groups can show that any effort by the nursing staff even drop placebo may have an effect on sleep quality. Damask rose extract was not found to have a significant effect on quality of sleep in control group compared with the control group. It is recommended to replicate the study with longer duration of intervention and/ or changing the method of damask rose administration.

Aim. The aim of this paper is to review studies related to fatigue in patients with heart failure.
Background. Fatigue is a subjective feeling and a multifactorial phenomenon in patients with heart failure. Fatigue is an important symptom of heart failure; however, lack of information exist regarding this phenomenon. Also, fatigue is considered as a challenge by health care providers and clinical guidelines have paid less attention to fatigue in these patients.
Method. This article reviewed studies published regarding fatigue in patients with heart failure. The studies were searched out through scientific databases, including PubMed and Science Direct by the keywords fatigue, predictors, related factors, heart failure and their Persian equivalents.
Findings. The literature review revealed that the prevalence of fatigue in patients with heart failure is high and different findings have been reported regarding its severity in these patients. Fatigue and its increasing trend during the disease progress is related to unsatisfactory quality of life and clinical outcome. In various studies, multiple factors including the nature of the illness and psychological factors particularly depression have been reported as predictors of fatigue and its severity in patients with heart failure. Few studies were conducted with the aim of evaluating the effect of non-pharmacological intervention on management of fatigue in these patients.
Conclusion. According to the high prevalence of fatigue in patients with heart failure, it is essential to consider timely interventions by health care providers, particularly nurses, for reducing it and improving patients’ well-being. Regarding the limitation of studies and importance of reducing fatigue, it is necessary to conduct further research to evaluate the effect of non-pharmacological interventions on symptom management (especially fatigue) in these patients.

Aim. This review examines cardiovascular diseases as the most common disease of the elderly population¡ and discusses about causes and methods of prevention¡ mitigation and treatment.
Background. Nowadays¡ with increased level of health and life expectancy¡ the phenomenon of elderly and increase in chronic diseases is a main issue. In modern societies¡ aging and diseases of this period of life create a high cost for health care system.
Methods. This review was conducted by searching out databases such as Google Scholar¡ Elsevier¡ PubMed¡ PMC¡ and Springer for the time period of 2008 to 2016.
Findings. In addition to the impact of aging on the body organs¡ especially the cardiovascular system¡ many factors including biological factors¡ lifestyle¡ risk factors for heart disease¡ underlying disease¡ psychosocial factors and personality factors¡ may influence the acuity of cardiovascular diseases. During aging¡ many irreversible changes occurs in all body systems including cardiovascular system. These changes cause hardness¡ thickening and narrowing of the arteries. With the narrowing of the heart arteries and increased blood pressure¡ the heart needs to work harder to pump the blood¡ resulting in left ventricular hypertrophy. Impaired cell growth and proliferation of fibrous tissue occurs as a result of the problem in production of impulse and electrical conductivity of the heart. Increase in volume of the left ventricle and blood vessel narrowing lead to ischemia of the heart. Early heart disease with progression to irreversible heart failure results in disability¡ exercise intolerance¡ and taking multiple medications in elderly¡ and ultimately¡ death may occur. By understanding the mechanisms of aging and cardiovascular disorders and modifying influential factors¡ the process of development of cardiovascular disease can be slowed down and the complications can be prevented.
Conclusion. Aging may lead to irreversible cardiovascular disease with the ultimate result of chronic heart failure. Compliance with lifestyle modification may prevent early occurrence of this phenomenon and some of its complications such as disability and death.