فصلنامه پرستاری قلب و عروق
سال پنجم شماره 3 (پیاپی 19، پاییز 1395)

Aim. The present study aimed to examine the suicide ideation and intensity and dimensions of pain in people with cardiovascular disease compared with healthy people.
Background. A few researches have done in relation to the suicide ideation and the amount of pain and dimensions of pain.
Method. The research design was descriptive-comparative. Sample size consisted of 182 people including people with cardiovascular disease (n=91) and healthy people (n=91). The participants were recruited by convenience sampling from Emam Reza Clinic in Shiraz, Iran within a three-month period. Participants completed demographic form, and pain and suicide ideation questionnaires. Data were analyzed by analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) in SPSS version 21.
Findings. People with cardiovascular disease reported more suicide ideation and experienced more pain than healthy people. Moreover, people with cardiovascular disease had higher scores in all three dimensions of pain (sensational-physical, emotional-affective, and cognitive). The result of ANCOVA showed that after controlling pain variable, statistical significant difference between groups’ suicide ideation was removed .
Conclusion. It can be concluded that people with cardiovascular disease suffer from suicide ideation and emotional and cognitive pain along with physical pain. Pain also plays an important role in the incidence of suicide ideation in people with cardiovascular disease.

Aim: The aim of this study was to examine the effect of Mindfulness Based Stress Reduction (MBSR) on physical functioning and Health Related Quality Of Life in people with Coronary Artery Disease (CAD).
According to the studies, CAD can affects physical functioning and HRQOL. Developing and examining psychological therapeutic models for improving quality of life and physical functioning would be appropriate.
In this randomized clinical trial study with control group, 30 people with CAD were selected from coronary care unit of Abbasi Hospital of Mian-E-doab city, Iran, by convenience sampling and assigned randomly to experimental and control group. Data were collected by Seattle Angina Questionnaire (SAQ) for measuring for assessing health related quality of life and SF-36 for measuring physical functioning. The experimental group received mindfulness-based stress reduction program in eight 2.5 hours sessions, weekly. The control group did not receive any intervention.
Findings: The results showed that after controlling the pre-test effect, mindfulness-based stress reduction had a statistically significant effect on physical functioning and health related quality of life and their dimensions.
It can be concluded that mindfulness-based stress reduction influences physical functioning and health related quality of life by modulating biological and psychological processes.

Aim. The aim of this study was to examine the effect of Benson relaxation technique on anxiety of critical care nurses.
Background. Anxiety is one of the important factors affecting nursing profession and the quality of care. Some complementary interventions such as Benson relaxation techniques may affects anxiety.
Method. This was an experimental study (pretest-posttest with control group design) in which 63 critical care nurses of Shahid Rajaie Cardiovascular, Medical and Research Center, Tehran in 2015. Stratified samples were selected based on ward and randomly allocated to to experimental and control group. Benson relaxation technique was implemented by experimental group for 20 minutes, twice a day, with at least six hours interval, and for a two weeks period. Data were collected through demographic questionnaire and Spielberger questionnaire. Data were analyzed in SPSS version 21 using Chi-square test, t-test, Fisher's exact test and repeated measures ANOVA.
Findings. In experimental group, the mean and standard deviation of anxiety, before the intervention and one and two weeks after intervention were 42.19±4.85, 43.67±7.55 and 42.12±6.12, respectively. A week after the intervention, the two groups had significant difference in terms of anxiety. The mean score of anxiety in the control group was more than nurses in the intervention group (P=0.011). Also, following application of Benson relaxation, anxiety intensity decreased in the intervention group as compared to baseline. In the control group, the mean score of anxiety increased overtime.
Conclusion. Implementation of Benson relaxation can reduce the anxiety of critical care nurses. This method is proposed as part of the nurse's anxiety reduction programs by managers and officials in medical centers.

Aim. The aim of this study was to compare quality of life (QoL) before and after angioplasty in people with coronary artery disease.
Background. The quality of life among people with CAD who undergo angioplasty treatment is of great interest because of the increasing number of patients receiving this treatment modality.
Method. In this descriptive analytical study, 473 patients with CAD admitted to all teaching hospitals of medical sciences universities located in Tehran were recruited through stratified random sampling over the years 2015-16.Quality of life in patients was measured before angioplasty, and one month and three months after angioplasty using SF-36 questionnaire. Reliability of this questionnaire has been reported in previous studies as 0.77-0.90 (Cronbach's alpha coefficient). Data were analyzed by Wilcoxon, Mann-Whitney and Kruskal-Wallis tests in SPSS version 23.
Findings. The results showed that angioplasty has increased the mean score of quality of life in total and also, in all dimensions, one and three months after surgery (P≤0.0001). The relationship of quality of life with all demographic variables (age, marital status, occupation, education level, place of residence, conditions of residence and type of insurance) was statistically significant except for gender.
Conclusion. The angioplasty is well able to improve the quality of life in different dimensions in the short term.Angioplasty can be recommended as a procedure with strong and positive effect on the health conditions and quality of life in people with CAD.

Aim. This study was conducted to examine the effect of combined inhalation of lavender oil, chamomile and Neroli oil on vital signs of patients with acute coronary syndrome.
Background. Increase in vital signs in patients with acute coronary syndrome worsens the disease and increases anxiety. The use of complementary medicine for better patient outcomes has been usually considered by the nurses due to the low complications and relatively low costs.
Method. This was a single-blinded, randomized clinical trial that carried out at the Emam Sajad Hospital in Shahryar, Tehran, Iran in 2016. After obtaining the approval from the Ethics Committee of Iran University of Medical Sciences, 75 patients aged 20 to 80 years who signed the informed consent were recruited and randomly allocated into three groups (control, placebo, and intervention groups) using block randomization design (25 subjects in each group). In the intervention group, patients were asked to strew 2 drops of the aroma on an eye pad, keep their hands at the distance of 5 cm from their nose and take deep breath 10 times. After this, the pad was placed beside the pillow of the patient until the next morning. In the placebo group, this process was carried out using distilled water and the control group received routine care. The patients’ vital signs were measured before intervention, one hour after and every four hours after intervention until the next morning. Data were analyzed in SPSS, version 22, using chi-square test, t-test and ANOVA.
Findings. Before intervention, there was no statistically significant difference between three groups in terms of demographic characteristics as well as pulse rate, respiratory rate, systolic and diastolic blood pressure. The results showed that the combination of three aromas decreased pulse rate, respiration rate, systolic and diastolic blood pressure in one, four, eight and twelve hours after the intervention in the aromatherapy group compared to the time before the intervention.
Conclusion. The use of aroma as a complementary method in patients with acute coronary syndrome could decrease their pulse rate, respiratory rate, systolic and diastolic blood pressure. Due to the low risk and suitable accessibility to these aromas, the results can be used by nurses in the critical care unit and patient caregivers to improve patient's vital signs.

Aim. The aim of this study was to examine the effect of incentive spirometry and deep breathing exercises on arterial blood gas parameters after coronary artery bypass graft (CABG) surgery.
Background. After CABG, pulmonary complications and oxygenation disorders are common and play an important role in post-operative mortality and morbidity. The different methods are being used for improvement of pulmonary function and oxygenation after CABG.
Method. In this clinical trial study, 75 patients who were candidate for CABG surgery were recruited and randomly allocated to two intervention groups (incentive spirometry group and deep breathing exercise group) and control group. The groups were compared in terms of arterial blood gas parameters (PaO2, PaCO2 and SaO2) before surgery, and on the first day, the second day, and the third day after surgery.
Findings. The study findings showed that in the third postoperative day, there was a statistically significant difference between intervention groups and control group in terms of the mean of arterial blood gas parameters (PaO2, PaCO2 and SaO2).
Conclusion. Incentive spirometry and deep breathing exercise are both significantly effective on improvement of arterial blood gas parameters (PaO2, PaCO2 and SaO2).

Aim: This study aimed to review indications, benefits, limitations and procedure of continuous ST segment monitoring in critical care unites.
Although the 12-lead electrocardiography is a standard and reliable tool to detecti ischemia in Acute Coronary Syndrome (ACS) patients, but it provides only a static snapshot. The American Heart Association (AHA) and American Association of Critical Care Nurses (AACCN) practice standards for ECG monitoring recommend continuous ischemia monitoring for all patients at risk of myocardial ischemia.
This was a review study. International databases such as Proquest, CINAHL, PubMed, Scopus and one national database (SID) were searched out using the keywords; ST-segment Monitoring, Cardiac Monitoring and Acute Coronary Syndrome to find out materials published between years 2000 and 2015. About 189 citations were evaluated, out of which 15 citations were recruited in the final review.
Findings: Although continuous monitoring of ST segment has been introduced many years, but this technology is not widely used.Continuous monitoring of ST segment provides a frequent and dynamic assessment of changes associated with ischemia.Continuous ST segment monitoring as an effective method can be used to provide continuous and dynamic snapshot of ischemia, to evaluate response to reperfusion and anticoagulant therapy and also, can be used for prognostic or research purposes.
Despite some limitations, the use of continuous ST segment monitoring is recommended for patients with ACS, besides routine assessment.

Aim: This study was designed to determine complications experienced by family members of patient admitted to intensive care units and to identify related factors.
Family is the most fundamental social community and has a basic role in human health. An acute illness of a family member and admission in critical care unit is considered as a stressful event resulting in some problems and undesirable outcomes for other family members.
This review study was done in a systematized manner and based on library literatures. To do this, the articles published on family of critical patients during 2004-2016, searched out in different Farsi and English databases using keywords of "patient's family", "critically ill patient", "and family need". After screening articles according to inclusion criteria, 20 related articles were reviewed and analyzed.
Findings: Admission of  patients in critical care unit cause some negative reactions and complications in their family in the form of physical and psychosocial disorders. These undesirable outcomes are related to different reasons usually related to patient’s caring method and the manner of interaction with family members.
In general, following admission of one of family member in critical care unit, the family encounters a crisis, loses its functions and experiences some problems. Based on this, nurses, as the main pillar of care delivery system, should be responsible about patients’ family, pay attention to their needs and support the family though developing a family-center care plan.