EISSN 2149-4975
Turkish Journal of Cardiovascular Nursing - Turk J Card Nur: 11 (26)
Volume: 11  Issue: 26 - Aralık 2020
RESEARCH ARTICLE
1. Blood Pressures may be Predictor of Cardiac Ischemia in Myocardial Perfusion Scintigraphy
Aykut Demırkıran, Elif Ijlal Çekirdekçi, Birol Topçu, Hatice Sümeyye Yavuz
doi: 10.5543/khd.2020.77699  Pages 105 - 110
Objective: Low diastolic blood pressure (DBP) is associated with adverse cardiovascular outcomes in patients with chronic coronary disease (CAD), but its association with ischemia is unknown. Relationship between DBP and the myocardial ischemia in myocardial perfusion scintigraphy (MPS) was investigated.
Methods: Patients with chronic coronary artery disease who underwent MPS were included. One day stress/rest gated MPI with Tc-99m MIBI protocol was applied to all patients. Blood pressures was measured before MPI. Patients were divided into 2 groups as ≤75 mmHg and >75 mmHg according to DBP. The SDS were calculated using the sum of the 17-segment.
Results: The patients with DBP ≤75 mmHG and with DBP>75 mmHG were compared, there was no significant difference in SDS (4.44±4.67 and 4.65±4.70 respectively; p=0.657). Association of DBP ≤75 mmHg with SDS appeared to be primarily among those with SBP >130 mmHg. Patients with DBP ≤75mmHg and SBP >130mmHg had different SDS (6.87±6.00 and 4.99±4.77; p=0.015) between patients with DBP >75 mmHg and SBP >130mmHg.
Conclusion: Coexistence lower diastolic blood pressures (≤75mmHg) with higher systolic blood pressures (>130mmHg) could be a predictor of myocardial ischemia in patients who underwent adenosine stress MPI.

2. Determination of Hypertensive Patients' Perceptions of Illness
Zekeriya Karadağ, Yeliz Akkuş
doi: 10.5543/khd.2020.79664  Pages 111 - 118
Objective: The aim of this descriptive study was to determine hypertensive patients’ perceptions of their illness and the factors affecting them.
Methods: This study was a descriptive study. The sample consisted of 210 hypertensive patients of a district state hospital. Data were collected using a descriptive characteristics form and the Illness Perception Questionnaire (IPQ).
Results: The mean age of participants was 70.36±11.39 years. Of participants, 40 percent were literate, and fifty percent were men. Participants had a mean IPQ subscale score of 18.89±3.25 (timeline acute-chronic), 19.86±4.72 (consequences), 21.59±4.49 (personal control), 17.32±3.37 (treatment control), 13.87±5.30 (illness comprehensibility), 13.33±3.49 (causal factors), and 21.31±5.74 (emotional representations). As for the scale of the causes of illness, participants had a mean subscale “psychological attributions,” “risk factors,” “immunity,” and “accident or chance” score of 23.71±4.26, 24.92±5.85, 9.30±2.95, and 5.31±2.02, respectively. Adherence to medication and exercises significantly predicted the subscales of timeline acute-chronic and consequences at a low level, while tobacco use significantly predicted the subscale of risk factors at a low level.
Conclusion: Hypertension is a chronic illness. Therefore, healthcare professionals should identify how patients with hypertension perceive their illness and train them on adherence to medication and exercises and quitting smoking.

3. Determination of Anxiety and Depression Levels in Patients with Early-Stage Coronary Artery Disease Detected with Computed Tomography Coronary Angiography
Mustafa Ahmet Huyut, Betül Çetintulum Huyut
doi: 10.5543/khd.2020.76768  Pages 119 - 124
Objective: The aim of this study is to evaluate the levels of anxiety and depression in the cardiology outpatient clinic patients diagnosed as early-stage coronary artery disease (CAD) by applying with computed tomography angiography (CTA).
Methods: In this study, consecutive 96 patients were included, 46 patients with CTA which were diagnosed with early-stage CAD, and 50 control patients. Demographic features, physical examination findings, cardiovascular risk factors, and laboratory parameters of all patients were recorded. In addition, participants were asked to fill the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) questionnaires. The results were evaluated at the 95% confidence interval and the significance level at p<0.05.
Results: In the cases involved in the study, 49 (51.04%) were female and the average age was 35.86±14.91 years. BDI results were significantly higher in the CTA group compared to the control group (17.61±8.95 vs. 9.88±7.77, p<0.001). In addition, a positive correlation was found between BDI and body mass index, age, systolic blood pressure, and BAI results. The age factor was found as an independent predictor of early stage CAD with multivariate logistic regression analysis (OR=1.45, 95% CI: 1.04-2.03, p=0.028).
Conclusion: We have shown that depression levels can be higher in patients with early-stage CAD which were detected with CTA.

4. The Effect of Alternate Nostril Breathing Exercise on Regulation of Blood Pressure in Individuals with Hypertension
Gamze Uğur, Hilal Uysal
doi: 10.5543/khd.2020.92905  Pages 125 - 131
Objective: In this study as a simple randomization method was aim to evaluate the effect of alternate nostril breathing exercise on regulation of blood pressure in individuals with hypertension.
Methods: The study was conducted between October 2017 and March 2018 with patients (n=76) with essential hypertension who visited the internal medicine outpatient clinic of a training and research hospital. The patients (n=76) were divided into experimental and control groups according to the inclusion criteria. Patients in the experimental group (n=37) performed alternate nostril breathing exercise and those in the control group (n=39) sat silently for 15 min/day for a period of two weeks. The pre- and post-intervention blood pressure of patients in the two groups was measured in the clinic at the end of the first and second week; the pre- and post-intervention measurements of blood pressure were performed at home daily for two weeks.
Results: The study included 72.4% female patients and 27.6% male patients; the mean age of the patients was 52.4±6.9 years. The mean systolic blood pressure (SBP) of patients in the experimental group measured at the clinic in the second week was approximately 4 mmHg lower than that of the control group (p<0.05). In addition, the mean SBP of patients in the experimental group measured at home in the second week was approximately 3 mmHg lower than that of the control group (p<0.05).
Conclusion: Alternate nostril breathing exercises in addition to pharmacological treatment may regulate the blood pressure in patients with hypertension.

5. Evulation of Medication Adherence and Affecting Factors in Inpatients with a Diagnosis of Cardiovascular Disease
Abdullah Avcı, Meral Gün, Semra Erdoğan
doi: 10.5543/khd.2020.09609  Pages 132 - 139
Objective: In this study it was aimed to determine compliance to medication in patients receiving inpatient treatment due to diagnosis of cardiovascular disease and the affecting factors.
Methods: The descriptive study was conducted with 176 patients receiving inpatient treatment due to diagnosis of cardiovascular disease in the cardiology service in a university hospital and taking medication for at least 3 months. The study data were collected using the personal information form and Morisky Compliance to Medication Scale between June 13th-Occtober 28th, 2016. Number, percentage, arithmetic mean, t-test, One Way ANOVA, Levene test, Shapiro Wilk test and Pearson correlation analysis were used for statistical analysis.
Results: It was determined that 51.7% of individuals who were included in the study were male; majority of them were unemployed; half of them were diagnosed with diabetes as chronic additional disease; nearly half of them had been hospitalized for five times and above; and their age average was 65.39±7.73 years. It was found that nearly half of the patients used drugs for seven years or more, and more than half used six or more drugs per day and the mean score of the Morisk Medication Compliance Scale was 4.78±2.03 (low level). In addition it was determined that 40.9% of patients took unprescribed medication and they often took analgesics as unprescribed medication. In this study there was no significant difference between mean scores on medication compliance in terms of sociodemographic and clinical characteristics of patients (p>0.05). It was also determined that majority of patients did not know why they had to take medication (those known at minimum, respectively; cardiac glycosides 10.6%, beta-blockers 22.2%, angiotensin converting enzyme inhibitors 26.6%) and majority of them were not acquainted with the side effects of medications they took (those known at minimum, respectively; cardiac glycosides 0%, beta-blockers 7.7% and ACEII 8.5%, diuretics 12.1%).
Conclusion: In the study it was determined that half of individuals diagnosed with cardiovascular disease showed a lower complicance to treatment and majority of them were not acquainted with the effects and side effects of medications they took.

REVIEW
6. Nursing Care Based on Roy Adaptation Model in a Patient with Heart Transplantation
Eda Akyol, Özlem Ibrahimoğlu
doi: 10.5543/khd.2020.21043  Pages 140 - 148
Heart failure is a clinical syndrome with high mortality and morbidity and negatively affects the quality of life. Despite recent technical developments in support devices, heart failure has a poor prognosis. Heart transplantation has a positive effect on survival and enhance the quality of life in patients with heart failure. After transplantation, patients should be checked at regularly throughout their lives and lifelong follow-up rules should be established for these patients. At this point, the purpose of nursing care is to increase compliance with the transplantation process. Nursing care plan based on using models and theories specific to the nursing profession creates a common language by systematizing care. It also improves the quality of care. Roy Adaptation Model is a widely used model in defining the conceptual basis of nursing and standardizing the nursing care plan. According to Roy, human is a system that adapts to its environment by interacting with constantly changing environmental stimuli. In the process of heart transplantation, it is thought that the interventions that nurses will plan and implement specifically for the patient will have a positive effect on adaptation to both surgical intervention and lifelong treatment. This review examines nursing care based on Roy Adaptation Model in a patient with heart transplantation.

CASE REPORT
7. The Use of Pender’s Health Promotion Model in A Case with Transcatheter Aortic Valve Implantation
Öznur Erbay Dallı, Serap Özer, Fisun Şenuzun Aykar
doi: 10.5543/khd.2020.05924  Pages 149 - 154
Transcatheter aortic valve implantation (TAVI), which is recommended for patients with severe aortic stenosis and risk for open heart surgery, is a treatment method that provides an increase in quality of life and survival. Adopting multidisciplinary team concept after this procedure is important for patient’s careful and holistic approach, adaptation to life changes and the success of treatment. Nurses who provide one-to-one care to patients have important place in multidisciplinary team. In recent years, nursing care has been established within the framework of theories and models that help systematic and effective care. One of these theories is Pender's Health Promotion Model. Nurses can aim to make behavioral changes to create a healthy lifestyle for individuals with this model.
In this article, the care management process of a 65-year-old male patient with advanced aortic stenosis and dyspnea is discussed according to model and aimed to set an example for the use.

OTHER
8. Nurse-Led Cardiac Rehabilitation Clinic: Experience in Malta Mater Dei Hospital
Sibel Sevinç
doi: 10.5543/khd.2020.04274  Pages 155 - 158
Cardiovascular diseases are the leading factors in terms of mortality and morbidity in our country and in the world. Cardiac rehabilitation after an acute coronary event is considered a low-cost intervention; it improves prognosis by prolonging life while reducing recurrent hospitalizations and health expenditures. Evidence indicated that nurse case management and nurse-coordinated multidisciplinary prevention programs are more effective than usual in reducing cardiovascular risk and can be adapted to the circumstances of various health care facilities. In this article, a sample of Mater Dei hospital Nurse-Led Cardiac Rehabilitation Clinic in Malta is presented.

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