---

This study is a descriptive -analytical research which is designed to evaluate clinical skills of Nurses in coronary care units in affiliated hospitals of Tehran medical sciences University.The specific objectives of this research are as follows: Determining clinical skills of nurses in coronary care unit in the fields of patient assessment, intrepretation of Electrocardiogram, and ABG test administration, Iv therapy, educating the clients , caring the patients under cardiac catheterization and resuscitation ofcardio-pulmonary disorders. The population involved 50 nurses who were working in the coronary care units. The sample and population were the same. The researcher collected the data during a period of 3 months and observed the subjects minimum two full working shifts.The results indicated that nursing skills of the majority of the subjects towards the patientassessment was at weak level, one half of them had high level skill ofEKG interpretation(+90%), Meanwhile 2/3 of the subjects (68%) had a very weak skill (0-20%) in the field of ABGtest interpretation. One half of them had a medium skill for administration ofthe IV drugtherapy and all of them were at very weak levelforpatienteducation skills. More than one halfof these nurses had a good skill about nursing care of the patients under cardiaccatheterization. Finally, the last objective (Cardiac resuscitation skill) was not analysed due to afew cases.

---

This study was conducted to determine the effect of energy therapy Method on anxiety and incidence ofcardiacdysrhythmiainpatientsundercatheterization.Thenvestigated units consisted of 68 patients that were randomly assigned into 3 groups: 26 patients in case group, 21 patients in placebo group and 21 patients in control group . The case group underwent the course of study through energy therapy method for 10-15 minutes ,one hour before catheterization. Furthemore, placebo group received mimic energy therapy within the same period of time, i. e (the method was the same as energy therapy except in this method no energy was transferred, and the procedure was unreal and mimicking). Moreover the control group received no treatment.For collection of data, the questionare and observation checklist were used. The anxiety of the patients was measured through speilberger anxiety -test, an hour before and during catheterization.The cardiac dysrhythmia and dysrhythmia during catheterization were recorded on an observation checklist.The results showed that energy therapy had a significant effect on the situational anxiety of the investigated units in case group and through energy therapy, their anxiety were reduced, (p=000)however, it had no considerable effect on the anxiety related to the characteristic of the individuals. In addition to the above, energy therapy could be effective in reducing the incidence of cardiac dysrhythmia such as: sinus tachycardia, (p=0.00005),V.T (p=0.005), PAC(p=0.001)and PVC.(p=0.01) The results also showed that energy therapy is a method reducing the anxiety of the patients in catheterization room, it could also be effective in reducing the complications such as cardiac dysrhythmia regarding to catheterization. Therefore, the investigation hypothesis was approved.

---

One of man's fundamental needs is communication. Nurses within their specialty sense this need in their relationship with their patients, even though in some cases with physical impediments e.g. the placing of bypass tubes, this relationship is endangered. This study is a quasi experimental research, whose main aim is to compare the effects of two types of communication methods on anxiety and satisfaction in patients after cardiac and bypass surgery having intubation, warded at chosen hospitals affiliated to the Tehran University of Medical Sciences. According to the specific criteria, 90 patients were randomly selected by divided into two groups (experimental and control). The researchers met all patients the day before the surgery explained the reason and use of the picture chart for the experimental group and the routine communication methods for the control group. Therefore on the day of surgery communication was established with both groups with their own particular method. Data collection was done through a questionnaire consisting of: 1) demographic specification and clinical history, 2) Spielburger's questionnaire for obvious anxiety and 3) visual analogue scale (10cm) for patient satisfaction evaluation which is undertaken the day after surgery and after extubation. The results of the χ² test and the Fisher's exact test showed significant statistical differences between the two groups concerning the level of the patient's anxiety and satisfaction. The use of the picture chart for the experimental group, decreased patient's anxiety resulting from speech disability and increased their satisfaction with their communication with nurses as compared to the control group. Considering the beneficial results from using picture charts in establishing communication with patients, nurses with the help of devices, must try to create better relationships with intubated patients in the post-surgery period and provide them with more desirable services.

---

Background & Aim: Cardiac rehabilitation is one of the most effective ways of secondary prevention in patients with myocardial infarction manifestations. This study aimed to assess the effectiveness of cardiac rehabilitation on clinical manifestations of myocardial infarction in post-MI patients.

Methods & Materials: In this interventional study, 66 patients (58 males and eight females) with myocardial infarction who were hospitalized in public hospitals of Ahwaz were selected using purposeful sampling. The participants were randomly allocated into intervention and control groups. Data was collected using a self-structured valid and reliable instrument. The intervention group participated in an 8-week cardiac rehabilitation program. Data on the clinical manifestations were collected eight weeks later. Data were analyzed in SPSS.

Results: The results showed that there was significant differences between two groups in hypertension crisis (P=0.03), chest pain, dyspnea, fatigue and palpitation after the cardiac rehabilitation (P<0.001).

Conclusion: Cardiac rehabilitation program decreased the clinical manifestations of myocardial infarction in post-MI patients. It is recommended to perform this procedure in the post-MI patients.

 

---

Background & Aim: Anxiety is a common experience which is felt as uneasiness, non-specific threat, and activation of autonomic nervous system. The aim of this study was to assess the effect of muscular relaxation on anxiety level of patients underwent cardiac catheterization.

Methods & Materials: In this clinical trial, 118 patients who were expected to have a cardiac catheterization were recruited from an educational hospital at Tehran University of Medical Science. The participants were allocated to two groups, including muscular relaxation group (50 patients), and control group (68 patients). Data were collected using a questionnaire, and a self-report paper for recording anxiety level. Anxiety level was recorded one hour before cardiac catheterization in two groups. Then, the intervention group was asked to listen to the Benson muscle relaxation guide direction tape for 20 minutes through headphone. After using muscle relaxation in the intervention group and immediately before cardiac catheterization, the anxiety level of the respondents was recorded once more. Control group received standard nursing cares. Data were analyzed using χ², Fisher&aposs exact test, Kruscalwallis, Man-Whitney and Wilcoxon statistical tests in the SPSS.

Results: There were no significant difference between two groups in demographic characteristics and anxiety level before the intervention and one hour before cardiac catheterization. After the intervention, the anxiety level was significantly reduced in the intervention group (P<0.001) while it increased in the control group.

Conclusion: Based on the results of this study, Benson muscle relaxation significantly decreased anxiety level in patients who were expected to go for cardiac catheterization.

 

---

Background & Aim: Poor sleep quality is a common problem among patients hospitalized in the CCUs. This study aimed to determine the effect of environmental factors modification strategies on quality of sleep among patients admitted to CCU.

Methods & Materials: This was a quasi-experimental study with a single-blinded design. Sixty patients admitted to the CCU of Shariati hospital were divided into two experiment and control groups. Sleep quality was measured in the first day of admission and three days later using the Pittsburgh sleep quality index in both groups. In the intervention group, we implemented a modified work environment between the two measurements. Data were analyzed using the Chi-squared and t-test in the SPSS v.18.

Results: Findings showed a significant decrease in sleep quality in the control group after hospitalization, compared with the intervention group (P<0.001). There were no statistically significant changes in the sleep quality before and after hospitalization in the intervention group (P=0.053).

Conclusion: Using environmental factors mitigation strategies can improve sleep quality of patients admitted to CCUs.

 

---

Background & Aim: Nowadays, home-based cardiac rehabilitation (HBCR) program is one of the major methods that can improve the quality of life of patients following coronary artery bypass graft surgery. The present study aimed to investigate the effect of a HBCR on the quality of life of patients following CABG.
Methods & Materials: In this clinical trial, 104 inpatients at Golestan and Imam Khomeini hospitals in Ahvaz in 2017, based on permuted-block randomization were assigned to an intervention or a control group. The intervention group received four training sessions for four days at the hospital and then six sessions of home-based cardiac rehabilitation (at 2-week intervals for three months). The Mac-New quality of life questionnaire was completed by the intervention and control groups before the surgery and three months after CABG surgery. Data were analyzed using the SPSS software version 22.
Results: The postoperative mean scores for quality of life subscales and for overall quality of life in the intervention group were greater compared to the control group (P<0.001). The obtained effect sizes were 1.17 for the emotional, 1.42 for the physical, and 1.91 for the social subscales and 1.67 for the overall quality of life. The Eta-squared value (0.408) indicated that the effect of the home-based cardiac rehabilitation program on the quality of life was significant (P<0.0001).
Conclusion: The study findings suggest that the home-based cardiac rehabilitation program has positive effects on the various subscales of quality of life. HBCR is recommended as a cost-effective care model for all patients attending heart surgery centers.
Clinical trial registry: IRCT20171114037468N1
 
 

---

Background & Aim: The main care need of patients with myocardial infarction (MI) is continuous care, presenting an important challenge in the field of nursing care. Therefore, This study aimed to evaluate the effect of nurse-led home-based cardiac rehabilitation on adherence to therapeutic regimens in patients with MI.
Methods & Materials: In this randomized clinical trial study, 80 eligible patients were selected through convenience sampling from selected hospitals affiliated with Tehran University of Medical Sciences in 2020-2021. Subsequently, they were randomly allocated to either the intervention or control groups. The control group received routine education upon hospital discharge, whereas the intervention group participated in a nurse-led cardiac rehabilitation program conducted both in-person at home and online, comprising four 90-minute sessions once a week, and were monitored for two months. Participants completed socio-demographic and treatment compliance questionnaires before and three months after the intervention. The collected data was analyzed using descriptive and inferential statistics with SPSS software version 20.
Results: Both groups were homogeneous in most demographic variables (P>0.05). The mean and standard deviation of treatment adherence scores before the intervention in the intervention and control groups were 70.82±7.91 and 67.94±11.20, respectively (P=0.015). After the intervention, these values changed to 75.10±6.13 and 68.77±10.12, respectively, with a statistically significant difference observed between the two groups (P<0.001).
Conclusion: The results revealed that nurse-led home-based cardiac rehabilitation was effective in enhancing treatment adherence. Therefore, it is suggested that cardiac rehabilitation care be consistently extended to the home setting.
Clinical trial registry: IRCT20201006048953N