Passion for life: lived experiences of patients after coronary artery bypass graft

Coronary artery bypass graft surgery [CABG] improves the quality of life, increases survival, and influences the patient's mental and emotional aspects. Little information is available on the lived experience of Iranian patients after this surgery. Understanding the lived experiences of patients will help health professionals with better provision of high quality care. This hermeneutic phenomenological study aimed to understand the lived experience of patients after CABG. Van Manen's method was used to conduct the study. A semi-structured, face-to-face interview technique was employed to explore the experiences of the patients following surgery. Seven men and 4 women between 49 and 80 years old were interviewed. Passion for life was the main theme extracted from the participants' interviews. This theme comprised the three sub-themes of receiving attention from family, being hopeful, and being spiritually oriented. The results showed that the participants experienced passion for life after their surgery. This finding reveals that patients tend to find a new perspective on life and their health after surgery

[Relationship of blood transfusion and CPB with delirium]

Introduction: Delirium as a syndrome which is recognized by consciousness disorder and changing in cognition. Delirium patients after by-pass are a common neurological complication, which is a component of the cognitive disorder. A high percentage of these kinds of patients suffer from after surgery. Evaluation of risk factors [blood transfusions and the use of more than one unit CPB] after surgery can be a valuable step in order to highlight the importance of prevention and early detection of delirium. This study aimed to recognize some risk factors related to delirium in patient who had a by- pass operation.

Methods: This study is a cross - sectional. The number of participants was 370 patients who had a by-pass operation were studied by the continuous sampling method. Researcher referred to the selected clinical centers in Tehran to identify related patients to our study and then informed consents were obtained from all patients. Using the Delirium Screening Scale, we analyzed psychological condition of patients until they were discharged from the critical care unit daily. The personal information questioner was completed on the first day of analyzing the psychological condition. Then the gathered data was analyzed by the SPSS 16 statistical package.

Results: Our findings showed that there was no meaningful statistical relationship between the incidences of delirium with risk factors despite its being common among participants.

Conclusions: According to these factors it is not possible to predict incidence of delirium in patients after a by- pass operation. In other words, there is an equal chance of delirium incidences among all patients' regardless of having or not having these factors; therefore the analyzed factors of this study cannot be used to predict the delirium incidence.

[Experiences of living with coronary artery bypass graft: a qualitative study]

Coronary artery bypass graft is a critical intervention for patients with coronary artery disease. This surgery is associated with significant changes and unique experiences in lives of patients. This study was conducted to understand the experiences of patients with coronary artery bypass graft. This qualitative study was conducted using an interpretive phenomenological approach. Eleven patients were selected from outpatient cardiology clinics of Tehran Heart Center using purposive sampling method. Data were gathered through semi-structured in-depth interviews lasting 55-70 minutes. The van Manen six steps analysis was used to analyze the data. During the data analysis, the main themes of experiences of living with coronary artery bypass and rebirth were extracted. These themes contained living with healthy heart, feeling back to the young and attempts for health maintenance. According to the study, participants were inclined to maintain the new lifestyle, dietary changes and also adhere to medications prescription. Nurses can help patients with properly designed educational program based on experiences of the patients

[Face-to-face education vs. group education on knowledge and anxiety of patients undergoing coronary angiography]

Lack of knowledge about coronary angiography may cause anxiety and stress in patients. Implementing appropriate educational methods can be effective in decreasing the level of anxiety among these patients. This study aimed to compare the effects of face-to-face with group education on anxiety and knowledge of patients undergoing coronary angiography. This quasi-experimental study was conducted in Shaheed Rajaie Cardiovascular Center affiliated to Tehran University of Medical Sciences in 2012. Through consecutive sampling method, 84 hospitalized patients who were candidate for coronary angiography were selected and allocated into two educational groups. Data were collected using a demographic data sheet, the knowledge assessment questionnaire, and the Spielberg state-trait anxiety inventory. Patients in both groups received same educational content. The patients' knowledge and anxiety were assessed before and after the intervention. Data were analyzed using descriptive statistics and independent t-test and paired t-test. The finding showed that both face-to-face education and group education were effective in enhancing the knowledge of the patients. However, group education was more effective than the face-to-face education in reducing the patients' anxiety [P=0.049]. Health professionals, particularly nurses, can use group education as an effective and appropriate strategy to improve patients' knowledge and to reduce the anxiety among patients undergoing coronary angiography

[Effect of endotracheal suctioning education for nurses on patients' hemodynamic parameters]

Endotracheal suctioning [ETS] is a common invasive nursing procedure. Hemodynamic parameters changes during and after the procedure. If appropriate strategies do not be applied during the ETS, hemodynamic changes can be significant and life threatening in critically ill patients. The purpose of this study was to assess the effect of education of endotracheal suctioning on patients' hemodynamic parameters. This was a non-equivalent quasi-experimental study conducted in two critical care units in Hazarat Rasool hospital. All nurses working in these two units participated in the study in a period of two weeks. Systolic blood pressure, diastolic blood pressure and mean blood pressure of all patients who needed suctioning were measured before and after the endotracheal suctioning. We analyzed the data using the SPSS. At baseline, the systolic, diastolic and mean arterial blood pressures increased significantly [P=0.02] in the first and third minutes post-suctioning. In post-education phase, diastolic and mean arterial blood pressure increased significantly [P<0.001] in the first minute post-suctioning. In the third minute post-suctioning, systolic, diastolic and mean arterial blood pressure decreased [P=0.43]. The study findings showed significant changes in hemodynamic parameters after post-endotracheal suctioning. In this study, conducting endotracheal suctioning education improved the outcomes of hemodynamic parameters in patients. Educational programs can improve nursing care outcomes by preventing and minimizing hemodynamic changes during and after the suctioning in critically ill patients

[Effect of distraction on children's behavioral responses to pain during IV catheter insertion]

Pain is an unpleasant experience related to potential or actual tissue damage. Distraction is an effective technique to control pain. This study aimed to examine the effect of pressing a small soft ball during intravenous catheter insertion on pain related behavioral responses of children. A randomized clinical trial study was conducted in surgical ward of the Qods hospital in Qazvin, Iran in 2010. Sixty children aged 4-6 were selected through a simple randomized sampling method. The children were allocated into two equal intervention and control groups. Data were collected using the FLACC scale. In the intervention group, children were asked to press a soft ball during IV catheter insertion. The researcher marked the FLACC during the procedure. In the control group, no distraction was made during the IV catheter placement. The data were analyzed using descriptive statistics, independent-sample t-test, Chi square at P<0.05. There was no significant difference between the two groups in terms of demographic variables including gender, birth order, race, age and type of disease. In the intervention group, none of the children experienced severe pain during IV catheter insertion; and 63.3% of the children had moderate pain. In the control group, 50.0% of children had moderate pain and 23.3% of them experienced severe pain during IV catheter insertion. There was a significant difference in perceived pain between the children of two groups [P<0.001]. Distraction is an effective, non-expensive, and easy-to access technique to control and reduce pain in children during IV catheter placement. This study showed that distraction through pressing a soft ball was effective in reducing the behavioral responses of pain in children who underwent IV catheter placement