EISSN 2149-4975
Turkish Journal of Cardiovascular Nursing - Turk J Card Nur: 12 (27)
Volume: 12  Issue: 27 - April 2021
RESEARCH ARTICLE
1. Comparison of Efficiency of Mobile Learning Method and Expository Teaching Method in Cardiopulmonary Resuscitation Training in Nursing Students
N. Hazal Erikli, Asiye Durmaz Akyol
doi: 10.5543/khd.2021.82787  Pages 1 - 9
Objective: This study was planned to evaluate the effect of mobile learning on the development of cardiopulmonary resuscitation knowledge in nursing students. The sub-objectives of the study are to assess whether there is a difference between mobile learning and narrative and learning groups and to ensure that the results obtained are a guide to the education curriculum.
Methods: The study included 60 people studying at the 3rd grade of Ege University Nursing Faculty. As data collection form; a data form questioned for sociodemographic information, and a form for determining the level of information for CPR, consisting of 40 questions, about general information about CPR, basic life support, and information about support for advanced cardiac life.
Results: The average age of participants in our study was 21.8 ± 0.9 (min: 20-max: 24) years. 85% of the students were female and 15% were male. When the expression method group is evaluated within itself; It was determined that the difference between the points taken by the students before the expression, the test performed immediately after the lecture, the last test after one week and the retesting stage after one month were statistically significant (p<0,001). When the mobile learning method group is evaluated within itself; The difference between the points taken by the students in the pre-test, post-test and retest stages was statistically significant (p<0,001). When the mean scores of the two groups were compared, it was determined that the difference between the groups was not statistically significant.
Conclusion: Nursing students must be teached more effective cardiopulmonary resuscitation with theoretical and practical training in the light of updated information, and as a result, more survival can be achieved with less neurological damage.

2. Use of Herbal Product in Complementary and Alternative Treatment in Patients with Hypertension
Nurten Terkeş, Zeynep Özer, Güldane Ayaz
doi: 10.5543/khd.2021.38233  Pages 10 - 17
Objective: The purpose of this study is to investigate the conditions of patients with hypertension using herbal products.
Methods: The study population consisted of patients who visited the cardiology outpatient clinic of a university hospital between August 15 and October 30, 2016 and received ambulatory treatment. The sample group was composed of 313 individuals with hypertension who fulfilled the inclusion criteria. Data were collected using the Personal Information Form and Complementary Therapy Application Form developed by the researcher.
Results: Mean age of the participants was 59.74±15.15 years, 53.7% were women, and 81.2% were married. Mean duration of hypertension was 10.96±8.28 years, and all participants had at least 1 chronic disease. In this study, herbal product use in patients with hypertension was 57.5%. The most frequently used herbal products were lemon (41.9%), garlic (36.7%), and olive oil (15.3%). Of the patients with hypertension participating in the study, 73.3% did not inform the healthcare professional about the complementary therapy they used. The relationship between the age and duration of diagnosis of the patients and the use of complementary therapy is statistically significant (p<0.05). The difference between gender, marital status, educational status and occupation and using complementary therapy was found to be statistically insignificant (p>0.05).
Conclusion: It was determined that the patients who participated in the study used herbal complementary therapies. It is thought that healthcare professionals should support their patients in using complementary therapies and inform them about wrong practices.

3. Cardiovascular Disease Risk Awareness Assessment Questionnaire: Psychometric Properties of the Turkish Version
Birgül Vural Doğru, Hediye Utli, Emine Karaman
doi: 10.5543/khd.2021.05914  Pages 18 - 25
Objective: This study aimed to evaluate the psychometric properties of the Turkish version of the Cardiovascular Disease Risk Awareness Assessment Questionnaire.
Methods: This methodological study was conducted with 301 healthy individuals between April and August 2018. The study sample consisted of relatives without cardiovascular disease of patients who applied to the cardiology outpatient clinic of two state hospitals in Mardin, Turkey. Data were collected using the Individual Information Form and the Cardiovascular Disease Risk Awareness Assessment Questionnaire. The translation-back translation method was used for language equivalence of the scale. The content validity index was calculated by expert opinion. In examining the construct validity of the scale, explanatory factor analysis was used. For reliability analysis, Cronbach’s alpha internal consistency analysis and the test-retest method were used.
Results: This study found that expert opinion was taken to achieve scope validity. In the exploratory factor analysis to evaluate construct validity, the factor loads of the scale items were between 0.515 and 0.935. Total score correlations were reported within a range of r=0.019-0.796 (p<0.05). The Kaiser-Meyer Olkin value of the scale was calculated as 0.715, and Bartlett test χ2 value was found to be 3,739.526 (p=0.000). The Cronbach alpha internal consistency coefficient was calculated as α=0.809. Scale test-retest correlation coefficient was found to be 0.864 (p<0.01).
Conclusion: The research findings show that the questionnaire is a valid and reliable tool for Turkish society to diagnose cardiovascular disease risk.

4. Validity and Reliability of the Turkish Version of the Coronary Artery Disease Education Questionnaire-II (CADEQ-II)
Esra Akbulut, Burcu Bayrak Kahraman
doi: 10.5543/khd.2021.60362  Pages 26 - 35
Objective: The aim of this descriptive study is to perform validity and reliability analyses of the Coronary Artery Disease Education Questionnaire-II (CADEQ-II) developed to identify and assess the knowledge level of patients with coronary artery disease about the disease and their educational requirements to be used in Turkey.
Methods: The population of this validity and reliability study for Turkish use consisted of individuals who visited the cardiology polyclinic of a university hospital and were monitored with a diagnosis of coronary artery disease. A total of 316 volunteer patients who applied to the polyclinic when the study was conducted were included in the sample. The data were collected using the Patient Identity Form, including the descriptive characteristics of the patients, and the Turkish form of the CADEQ-II.
Results: The Cronbach’s alpha value of the questionnaire was 0.88. The Cronbach’s alpha values of the subscales of the questionnaire were 0.70 for the medical condition subscale, 0.66 for the risk factors subscale, 0.63 for the exercise subscale, 0.67 for the nutrition subscale, and 0.65 for the psychosocial risk subscale. The coefficients of relationship between the test-retest reliability results were adequate.
Conclusion: The CADEQ-II is a valid and reliable instrument for assessing the general knowledge levels and educational requirements of individuals with coronary artery disease in relation to medical condition, risk factors, exercise, nutrition, and psychosocial risk. Assessing the patient education requirement with a measurement tool will contribute to the effective implementation of the patient education phase.

5. Cyberchondria Levels and Affecting Factors in Heart Patients
Sinem Güzel, Zülfünaz Özer
doi: 10.5543/khd.2021.94940  Pages 36 - 46
Objective: This study was performed to evaluate cyberchondria levels and affecting factors in heart patients.
Methods: This descriptive cross-sectional study included 345 patients admitted to a cardiology clinic for inpatient treatment. Data were collected via Patient Information Form and Cyberchondria Severity Scale (CSS).
Results: Mean age of the patients was 59.2±10.3 years; 65.5% were male, 81.4% were married, 36.2% had a bachelor’s degree, 28.1% were retired, and 62% had an intermediate monthly family income. Among the patients, 56.8% had a heart condition for 1-5 years, and 34.2% had surgery for their heart condition. Overall, 52.5% had seen a physician 3-5 times during the last year, 48.1% evaluated their own health condition as intermediary, 16.2% stated that they did an internet search on their complaints before seeing the physician, and 10.1% stated that they did an internet search before starting the therapy given by the physician. Mean total CSS score was found to be 75.47±30.83; among the subscales, compulsion score was 14.87±7.80; distress score was 17.17±7.52; excessiveness score was 19.47±8.55; reassurance score was 13.44± 6.30, and mistrust to physician score was 10.23± 4.81. CSS mean scores were found to be statistically higher in patients older than 30 years of age, full-time employees, patients having a heart condition for less than a year, patients who had seen a physician 3-5 times during last year, patients who did an internet search on their complaints before seeing a physician, and patients who did an internet search before starting their physician-given therapy regime (p<0.05).
Conclusion: Patients were determined to have intermediate level of cyberchondria. Gender, age, education status, and data on disease were found to affect cyberchondria levels of patients.

6. Are the Alarm Settings of the Monitors in Intensive Care Units Correct Enough?
Serap Gökçe Eskin, Feyza Er, Sakine Boyraz, İbrahim Kurt
doi: 10.5543/khd.2021.94695  Pages 47 - 51
Objective: Monitoring has vital importance in following intensive care patients. This study planned to determine whether the lower and upper limits of the alarm settings of the monitors actively used in a university hospital adult intensive care unit (ICU) were adjusted and to reveal the appropriateness of these limits.
Methods: The lower and upper alarm limit settings of each monitor were photographed once. The photographs were evaluated by the anesthesiologist in the research team in terms of pulse rate, respiratory rate, systolic blood pressure, diastolic blood pressure (DBP), and oxygen saturation for lower and upper limits and appropriateness.
Results: The lower and upper limits of heart rate settings were found to be adjusted in 100% of the monitors in ICUs of surgical and internal units, and the majority of them were within the appropriate value range. The alarm limits of 92% of the monitors in the ICUs of internal medicine units were found to be set, and 84% were appropriately adjusted. A total of 83 monitors in 10 ICUs were examined. The upper and lower limits of the respiratory rate were not set in any of the monitors examined. According to the results of the study, it was observed that the alarm settings of the DBP and respiratory parameters of intensive care patients had not been set. It was found that SpO2 lower limits for 3 monitors had been set in only one group of ICUs, but that none of them had been adjusted appropriately.
Conclusion: Monitor alarm limits in ICUs are generally not set appropriately. According to these results, we recommend that all monitors in ICUs should be adjusted correctly to fit the clinic of the patient and lower and upper limits.

REVIEW
7. What to Do for Patients with Hypertension During COVID-19?
Seçil Beyece İncazlı, Serap Özer
doi: 10.5543/khd.2021.90267  Pages 52 - 58
Hypertension is one of the most common comorbid diseases with the new coronavirus disease 2019 (COVID-19) and is an important risk factor for mortality. Patients with hypertension have a poor prognosis, but there is no evidence that hypertension increases the risk of new infections or adverse outcomes, regardless of age or other risk factors. At the beginning of the pandemic, controversial statements were made that some drugs frequently used in the treatment of hypertension increased morbidity and mortality owing to COVID-19. However, there is no scientific evidence to support these explanations, and the need to continue drug therapy is emphasized. Efforts to monitor and maintain physical and psychological well-being are the most important issues to be considered in patient management strategies during the pandemic. For the subsequent management of patients with hypertension, home blood pressure monitoring strategies will facilitate good blood pressure control by maintaining social distance. The purpose of this review article is to examine the studies investigating the relationship between the COVID-19 pandemic and hypertension in the literature, to convey the latest guideline-based information on the effective management of hypertension, and to emphasize the necessity of using technological approaches in nursing practices to maintain the effective management of hypertension in this process.

8. Effects of COVID-19 on Cardiovascular System and Nursing Care
Ayfer Hiçerimez, Nuray Enç
doi: 10.5543/khd.2021.93723  Pages 59 - 67
In December 2019, an outbreak of pneumonia caused by a novel coronavirus occurred in Wuhan, China, and the disease spread rapidly all over the world. Coronavirus disease 2019 (COVID-19) directly or indirectly affects the cardiovascular system; in cases of concomitant cardiovascular disease, the morbidity and mortality rate increases. Nurses, who are at the forefront of the fight in the COVID-19 pandemic, have an active role and responsibilities in disease management. The purpose of this review is to evaluate the effects of COVID-19 on the cardiovascular system, its relationship with underlying mechanisms, and its treatment and to prevent cardiovascular risks in line with the nursing care process to plan and implement interventions.

CASE REPORT
9. Nursing Care According to Riehl’s Symbolic Interaction Model in a Patient Receiving ECMO Treatment Due to ARDS Developing After H1N1 Diagnosis: Case Report
Esra Özkan, Yeşim Yaman Aktaş
doi: 10.5543/khd.2021.35119  Pages 68 - 74
Extracorporeal membrane oxygenation (ECMO) support is seen as a life-saving system in severe respiratory failure. This system is a treatment method that is not widely used and is not known sufficiently in our country. Optimal nursing care in the preparation, administration, and termination of ECMO treatment is one of the important factors that play a role in the positive outcome of the prognosis. A patient, who was admitted to the emergency department with a complaint of breathing problems, was admitted first to the infection clinic and then to the intensive care unit because of low oxygen saturation values. The patient was followed up with mechanical ventilator support, and ECMO treatment was applied for 7 days. In the case evaluated according to Riehl’s Symbolic Interaction Model, nursing diagnoses were determined and nursing interventions were applied for these diagnoses.

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