1 2251-8983 Iranian Cardiac Nursec Society 36 Cardiovascular The effect of planned breathing exercises on oxygenation in patients after coronary artery bypass surgery Moradyan Tayeb b Farahani Mansoure c Mohammadi Nooreddin d Jamshidi Roohangiz e b Baqiyatallah University of Medical Sciences, Tehran, Iran c Center for Nursing Care Research, Department of nursing Education and Administration, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran (*Corresponding Author) d Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran e Department of Biostatistics, Faculty of Management and Medical Information, Tehran University of Medical Sciences, Tehran, Iran 1 6 2012 1 1 8 14 15 07 2012 14 08 2012 AimThe aim of this study was to evaluate the effect of planned breathing exercises on oxygenation in patients undergoing coronary artery bypass surgery.BackgroundPulmonary complications and impaired oxygenation are common after coronary artery bypass graft surgery and cause increased hospitalization and health care costs. Breathing exercises are applied commonly in managing coronary artery bypass graft (CABG) patients in many hospitals, but scientific evidence is not sufficient about the efficacy of this treatment.MethodIn a clinical trial , 100 patients undergoing CABG were randomly allocated to planned breathing exercises (n=50) and control group (n=50). The patients in experimental group received breathing exercises protocol (deep breathing, incentive spirometry and directed cough maneuvers) and the patients in control group received daily routine hospital physiotherapy. Other therapies were similar in two groups. Arterial blood gases were compared between groups before operation and the first, second and third postoperative day. The data were analyzed by SPSS Version 17 software using chi square, T test and analysis of variance.FindingsThe study findings showed no statistically significant difference between groups in terms of demographic data, history of chronic diseases, Pao2 and Sao2 before surgery and on the first and second day after surgery. On the third postoperative day, the mean score of SaO2 (95, SD=2.47 vs. 93.24, SD=16.3, p=0.003) and PaO2 (83.19, SD=16.23 vs. 72.66, SD=13.20, P≤0.001) were higher in the experimental group.ConclusionThe patients receiving planned breathing exercises including deep-breathing exercises, incentive spirometry and directed cough maneuvers have better oxygenation after coronary artery bypass surgery.
37 Cardiovascular The effect of endotracheal suctioning in-service education on patients’ oxygen saturation and heart rate chan ges in intensive care unit Nooredin Mohammadi f Parviz Shohreh g Peyrovi Hamid h f Center for Nursing Care Research, Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran (*Corresponding Author) g School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran h Center for Nursing Care Research, Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran 1 6 2012 1 1 16 23 16 07 2012 14 08 2012 AimBackground The purpose of this study was to measure the effect of endotracheal suctioning in-service education on the patients’ blood oxygen saturation and heart rate changes in intensive care unit.One of the basic steps in caring and maintaining the airway is endotracheal suctioning. If this procedure is not performed with proper technique, it will be associated with many complications.Method This study is an outcomes research performed in medical intensive care unit of Hazrate-Rasool Hospital in 2010. All nurses working in intensive care unit and all performed endotracheal suctioning cases in a period of two weeks before and after in-service education were selected as research sample.FindingsConclusion Therefore, it is necessary to provide in-service education programs in relation to nurses' attention to the hemodynamic changes and to minimize these changes, and thereby to protect life and safety in critically ill patients.The results showed mean arterial oxygen saturation decreased significantly (p =0.005) in the first and third minutes post-suctioning before conducting in-service education. Besides, the results showed the mean arterial oxygen saturation increased significantly (p≤0.001) in the first and third minutes post-suctioning after conducting in-service education. Also, mean heart rate increased significantly (p≤0.001) in the first and third minutes post-suctioning before conducting in-service education. The mean heart rate increased significantly (p≤0.001) in the first minute post-suctioning after conducting in-service education, but in third minute post-suctioning this difference was not significant.The research findings show significant changes in blood oxygen saturation and heart rate post-endotracheal suctioning. These changes are an important complication in critically ill patients and can be life-threatening particularly. 38 Cardiovascular Comparative study on the quality of life amongst asthmatic boys and girls aged between 7-17 in Zanjan Salman-Yazdi Nahid i Ghasemi Iran j Salahshourian Asieh k Haghani Hamid l i Department of Pediatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran j Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Azad Islamic university of Zanjan, Iran, (*Corresponding Author) k Department of Nursing Education and Administration, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran l Department of Biostatistics, Faculty of Management and Medical Information, Tehran University of Medical Sciences, Tehran, Iran 1 6 2012 1 1 24 29 16 07 2012 14 08 2012 AimThe aim of this study was to compare the quality of life amongst asthmatic boys and girls aged between 7-17 in Zanjan BackgroundThe quality of life in patients with chronic disorders is highly affected by the diseases, especially when such variables as gender and age interfere with the situation. Youngsters suffering from asthma face numerous physical, social and psychological problems. MethodIn a descriptive-comparative study, 290 asthmatic children aged between 7-17 "minimum after six month of the disease were selected by consecutive sampling method. Demographic information form and Asthma Quality of Life Questionnaire (AQLQ) were completed by parents. The data were analyzed by SPSS software using T test, Mann- Whitney U and analysis of variance. FindingsThe study findings showed the mean score quality of life was (50.56, SD=19.45) for girls and (36.02, SD=16.49) for boys. Statistical analysis showed a significant difference between the quality of life amongst asthmatic boys and girls (p=0.012). Conclusion The difference between the quality of life in asthmatic boys and girls should be considered when planning programs to enhance their quality of life. Thus, it is proposed the quality of life to be tested in both genders, in different ages with different chronic diseases. 39 Cardiovascular Comparison of the attitudes of the last-year nursing and medical students about spiritual care Shahrabadi Reza m Masroor Daryadokht n Hadjizadeh Sakineh o Hosseini Fatemeh p m School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran (*Corresponding Author) n Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran o School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran p Department of Biostatistics, Faculty of Management and Medical Information, Tehran University of Medical Sciences, Tehran, Iran 1 6 2012 1 1 30 34 16 07 2012 14 08 2012 AimThe aim of this study was to compare attitude of the last-year nursing and medical students studying at Iran University of Medical Sciences, Tehran, Iran about spiritual careBackgroundThe spirituality is a complex and multidimensional concepts including cognitive, behavioral and experimental aspects. For promoting spiritual care we have to consider the physical, mental, emotional and spiritual aspects of the human. The studies showed that many patients believe that spirituality plays an important role in their life they believe there is a positive relationship between their recovery and religious and spiritual aspects. Many patients expect health care personnel consider these factorsMethodA descriptive comparative design was used to conduct the study. “Spiritual care perspective scale” (SCPS) was completed by 110 nursing and 220 medical students. Data were analysed by SPSS.FindingsBased on the findings, 56% of nursing students and 51.8% of medical students have positive attitude on the spiritual care of patients. There was no statistically significant difference between attitudes of the two groups of students. Nursing students had more favorable attitude about existing a superior force or transcendental existence influencing spiritual health. Medical students had more favorable attitudes about considering spiritual care as part of the caring performance.ConclusionPaying more attention to the spirituality and spiritual care in educational programs for those who provide health services seems to be necessary for educational planning authorities. It is required to improve culturally in the field of principles of beliefs and religion and their education among the young and educated people. It is necessary to improve the culture of religious believes through education among students. 40 Cardiovascular The effect of face-to-face education on knowledge, attitude, and believes of acute coronary syndrome patients about heart disease: an experimental study Zafari Shabnam Ghadrdoost Behshid Hanifi Zahra Khaleghparast-Athari Shiva Shahid Radjaee Cardiovascular Hospital, Tehran University of Medical Sciences, Tehran, Iran (*Corresponding Author) Shahid Radjaee Cardiovascular Hospital, Tehran University of Medical Sciences, Tehran, Iran Shahid Radjaee Cardiovascular Hospital, Tehran University of Medical Sciences, Tehran, Iran Shahid Radjaee Cardiovascular Hospital, Tehran University of Medical Sciences, Tehran, Iran 1 6 2012 1 1 36 41 17 07 2012 13 08 2012 Aim The aim of this study was to evaluate the effect of face-to-face education on knowledge, attitude, and believes of acute coronary syndrome patients about heart disease and their reaction to symptoms.Background Coronary artery disease is known as an important health issue. Mortality results from myocardial infarction are highly dependent on time interval between symptoms presentation and reperfusion intervention. Reperfusion leads to the best results, especially if started within the first 60 minutes after beginning the manifestations. Many studies have been conducted to examine strategies for decreasing delay time, but education through media has not received enough attention.Method In this clinical trial, 300 patients referred to Shahid Radjaee Cardiovascular Hospital and diagnosed as acute coronary syndrome were randomly allocated to receive either education and counseling as intervention (n=150) or regular education (control group, n=50). The inclusion criteria were: not having serious complicated co-morbidity such as psychiatric disorder, renal insufficiency, malignancies or neurologic disorders and speaking and comprehending Pesian. Data collection instruments were demographic form and Rapid Early Action for Coronary Treatment (REACT). Data were collected before intervention and one and three months after the beginning of intervention. The data were analyzed by SPSS.Findings The study findings showed high rate of reporting risk factors in both groups. Most patients of both groups had referred to cardiologist. In experimental group, knowledge, attitude and belief scores increased significantly, one and three months after the beginning of the intervention. Between group comparisons showed a statistically significant difference between two groups in terms of knowledge, attitude and belief scores (P≤0.0001).Conclusion Face-to-face education and counseling improves knowledge, attitude and believes of the patients about acute coronary syndrome, thereby, may reduces delay in treatment. Improvement of patients’ knowledge is the basic step for symptom management of the acute coronary syndrome. 41 Cardiovascular Peripheral venous pressure as a predictor of central venous pressure during coronary artery bypass graft surgery Peighambary Mohammad Mehdi Jalili Behnoosh Babaee Tooraj Alizadeh Ghavidel Alireza Heart Valve Disease Research Center, Shahid Rajaei Cardiovascular Medical & Research Center, Tehran University of Medical Sciences, Tehran, Iran Shahid Rajaei Cardiovascular Medical & Research Center, Tehran University of Shahid Rajaei Cardiovascular Medical & Research Center, Tehran University of Medical Sciences, Tehran, Iran Heart Valve Disease Research Center, Shahid Rajaei Cardiovascular Medical & 1 6 2012 1 1 42 46 17 07 2012 13 08 2012 Aim This study was conducted to assess the degree of relationship between peripheral venous pressure and central venous pressure in patients undergoing CABG. Background Although, cannulation of a large central vein is the standard method for monitoring central vein pressure and providing secure vascular access, this method has serious complications. Moreover, previous studies in adults have demonstrated a clinically useful correlation between central and peripheral venous pressure. Method In this cross-sectional study, 100 adult patients with the mean age of 61 years that underwent coronary artery bypass graft surgery in Shahid Rajaei Heart Center were enrolled. Peripheral venous pressure through a short 16-18 G catheter and central venous pressure through central line (inserted in right-internal jugular or subclavian vein) were monitored simultaneously in 5 stages: following the induction of anesthesia before, after and during cardiopulmonary bypass and after sternum closure. The results were analyzed by SPSS.   Findings Findings indicated that the mean value of peripheral venous pressure was 11 mmHg and the mean value of central venous pressure was 9.5 mmHg, therefore the mean difference was 2±0.5 mmHg. The correlation of peripheral venous pressure and central venous pressure was 0.95 (P≤0.001) in all 5 evaluating times. Changes in other parameters did not affect the relationship between these two parameters. Conclusion We concluded that peripheral venous pressure can be used as a predictor of central venous pressure in patients with coronary artery bypass graft surgery.