فصلنامه پرستاری قلب و عروق
سال ششم شماره 1 (پیاپی 21، بهار 1396)

Aim.This study aimed to examine the relationship between adaptability and quality of life in people whit heart failure.
Background.Heart failure has a chronic debilitating process that can be very influential on quality of life. The main outcome of heart failure is disability and limitation in doing family, social and occupational roles. One of the determinants of health and prevention of exacerbations in heart failure patients is adaptability with the disease.
Method.This Correlationalstudy was conducted on 200 people referring to Ekbatan Hospital located in Hamadan, Iran. Data were collected by demographic questionnaire, Bell Adjustment inventory, and Mac New Quality of Life Questionnaire. Data were analyzed in SPSS version 19 using descriptive and analytical statistics.
Findings.The mean age of the sample was 63.68±12.07 years. The meanscore ofadaptabilityand quality of life were76.16±6.81 and 126.85±20.45, respectively. There wasno statisticallysignificant relationshipofadaptabilityscore anddomains of quality of life ,except for the sexual domain of quality of life.
Conclusion. In people with chronic heart failure, an increase in adaptability may enhance the sexual quality of life.

Aim: The purpose of this study was to examine the effect of mindfulness-based cognitive therapy education on self-criticism and fear of failure in people with heart disease Background: Cardiovascular disease is already considered as the most common serious illness in advanced countries. Self-criticism and fear of failure may have a negative effect on physical health and cause heart disease. Method: In this experimental pretest posttest study with control group, the study population consisted of all people with heart disease referred to Mostafa Khomeini Hospital, located in Behbahan, Iran. Thirty patients with heart disease were recruited through consecutive sampling based on inclusion criteria and were allocated to either experimental (n=15) or control (n=15) group. The data collection tools included self-criticality test, fear of failure questionnaire. The practical guide for cognitive therapy based on mind-awareness was used to guide the intervention. Data were analyzed in SPSS 18 using descriptive and inferential statistics. Findings: The findings of this study showed that mindfulness-based cognitive therapy education reduced fear of failure (P≤0.0001, F=22.53) and self-criticism (P≤0.0001, F=22.23) in experimental group relative to control group. Conclusion: Mindfulness-based cognitive therapy education can be considered as an effective way for reducing self-criticism and fear of failure in people with heart disease.

Aim. The aim of this study was to examine the effect of self-management training and follow-up with phone calls or mobile social network on the blood pressure of people with hypertension.
Background. Hypertension is one of the main causes of preventable death worldwide, and self-management training and follow-up is of particular importance in these patients.
Method. This randomized controlled clinical trial was conducted on 100 patients with primary hypertension referred to AL-Zahra hospital, Isfahan, Iran in 2016. The patients were recruited through convenience sampling and were allocated by blocking randomization into four groups, control group, “self-management education without follow-up” group, “self-management education by social network follow-up” group (education and weekly follow-up for 6 weeks) and “self-management education by telephone follow-up” group (education along with weekly calls for 6 weeks). Data were collected before and 6 weeks after intervention. The data were analyzed using Chi-square test, ANOVA, and paired t-test in SPSS, version 16.
Findings. After intervention, the study groups were significantly different in terms of blood pressure (P ≤0.0001). According to Scheffe post hoc test, intervention groups (with and without follow-up) had a statistically significant difference regarding to the blood pressure when compared with compared with the control group (P≤0.0001). Scheffe post hoc test results showed that three interventions (education without follow-up, education with telephone follow-up and education with social networks follow-up) did not differ in terms of effect on systolic and diastolic blood pressure.
Conclusion. Self-management training and follow-up by telephone or mobile social network were effective on the blood pressure of people with hypertension. Nurses can take a positive step towards improving the management of hypertension with a comprehensive patient education and follow-up.

Aim: The aim of this study was to determine the effect of the implementation of clinical surveillance model on the amount of education provided to cardiac patients. Background: Clinical supervision is a relationship between nurse and observer that promotes the development of nursing professional skills. Method: This is a quasi-experimental before-after study without control group. The stratified sampling method was used to recruit 300 patients based on inclusion and exclusion criteria. The researcher used the data-gathering form to record teachings provided to patients by nurses and also, the rate of their registration in the medical record. Clinical surveillance model included planning, monthly meetings with health education volunteers, classified teaching, daily clinical supervision, follow-up, identifying the weaknesses of nurses in providing training to cardiac patients and corrective actions in a regular and continuous basis for one year. After the intervention, teachings provided to patients by nurses and also, the rate of their registration in the medical record were re-evaluated. Data were analyzed using descriptive and inferential statistics in SPSS version 19. Findings: After intervention, the amount of teaching provided by nurses at the time of admission, during hospitalization and at the time of discharge was significantly increased (P<0.001). The findings also showed that the patients were more satisfied with the received teaching after intervention (P<0.001). Conclusion: Continuous and regular monitoring has a significant role in the amount of education provided to patients by nurses. It is recommended to plan management and supervisory programs to be implemented for nurses involved in patient education.

Aim. This study was performed with the aim of determining the effect of peer education on self-efficacy in people with heart failure.
Background. Heart failure is a clinical syndrome which may have negative effects on self-efficacy. Given the positive role of education in improving self-efficacy, probing a suitable educational method to improve the self-efficacy of these patients is important.
Method. In this clinical trial study, 60 people with heart failure were recruited and randomly allocated to experimental (n=30) and control group (n=30). After preparing the peer group, four peer to peer training sessions were conducted during one month. Persian translation the self-efficacy questionnaire was used for data collection, which was completed by both groups, before, just and one month after the intervention. Data were analyzed in SPSS, version 21 and P values less than 0.05 were considered significant.
Findings. No statistically significant difference was observed between groups in overall self-efficacy score before the intervention. The mean score of self-efficacy, immediately after the intervention was 50.3±7.21 and24.9 ±1.7, in the experimental and control group, respectively, and a statistically significant difference was seen between the mean scores of the groups (P≤0001). The mean score of self-efficacy, one month after the intervention was 48.8±1.2 and 23.4±4.6, in the experimental and control group, respectively and paired t-tests showed a statistically significant difference between the mean scores of the groups (P≤0001)
Conclusion. Based on this study, Peer education intervention can be a beneficial educative-supportive approach and enhance the self-efficacy life of heart failure patients. Therefore, using this method is recommended in patients with heart failure patients.

Aim. This study was aimed to examine the effect of intravenous diuretic therapy hospitalization of people with heart failure patients.
Background. Heart failure is a progressive disease with a long term hospital admission; while having a standardized protocol can lead to a reduction in hospital costs and adverse effects of hospitalized days.
Method. This clinical trial (without control group) was conducted on 111 heart failure patients who received intravenous diuretic therapy (in 6 hours sessions) for at least one year in heart failure ward. This treatment was performed once a week in the first month, once in two weeks in the second to sixth month and once in month in the 7th to 12th month. During the treatment, patients were given training on nutrition, drug regimen and lifestyle modification. Outcomes included urine output, weight loss, hypokalemia, worsening of renal function, hospitalization and mortality rate.
Findings. The mean age of patients was 58.88±16.33. The minimum dose of prescribed diuretics was 20 mg and the maximum dose was 200 mg. Mean of urine output and weight loss were 1890±1101 ml and 3.04±5.91 kg, respectively. Transient worsening of renal function and hypokalemia occurred in 15 and 20 patients, respectively. During one year period, 31 patients (27.4%) need to be hospitalized.
Conclusion. Short courses of intravenous diuretic therapy in people with heart failure are a safe and effective method that may provide an alternative to hospitalization.

Aim. This review study was conducted to review the relationship between cardiovascular disease and vascular dementia in the elderly.
Background. The aging of the world population has increased dramatically. Chronic diseases related to aging, such as dementia, vascular and cardiovascular disease also have increased as a major health problem with a large impact on community health and family.
Method. The studies published between 2000 and 2017 were searched for in databases and search engines Google scholar, Pumped, Science Direct, Magiran, IranMedex, and SID by the keywords dementia, cardiovascular disease, hypertension, heart failure, cognitive impairment, elderly, older adult, and atrial fibrillation and their Persian meanings.
Findings. The factors such as high blood pressure, coronary artery disease, atrial fibrillation, heart failure and atherosclerosis are considered as the main causes of vascular dementia, especially in the elderly.
Conclusion. In the elderly, cardiovascular disorders, especially those with chronic nature have a considerable effect on cognitive performance impairment and vascular dementia.

Aim. The aim of this literature review was to investigate the effect of self-monitoring program on outcomes of heart failure (HF).
Background. Heart Failure is a chronic and progressive disease with an increasing prevalence. Self-monitoring program may help to recognize decompensated HF symptoms and taking proper and early action. However, its potential for improvement of HF outcomes has remained unknown.
Method. In this narrative review, databases such as PubMed, Scopus, Web of science, Embase, and Cochrane library was used for data collection. Searching out was conducted on 27 Feb, 2017 for published articles between 1961- 2017 by the keywords "self-monitoring", "heart failure", "outcome", and their English synonyms without language limitation. Inclusion criteria were content similarity to subject under study, clinical trial study design, and self-monitoring of weight and recording it in a diary by patient with HF.
Findings. Out of 13924 retrieved articles, titles and abstracts of 8384 papers were screened for inclusion criteria. Full- text of 20 related paper were downloaded. Finally, data related to 12 papers published between 1998 to 2014 were reviewed. Outcomes of self-monitoring program included HF- related hospitalization and Emergency Department (ED) visit, mortality, self-care, quality of life and other outcomes such as disease knowledge, phone call to health care provider, Ejection Fraction (EF), HF NYHA function class, Brain Natriuretic Peptide (BNP), and care cost.
Conclusion. Self-monitoring program has led to improve in HF outcomes. Therefore, giving weight and other symptoms self-monitoring diary beside self-care education will be recommended in order to increase patient’s engagement in his/her care.