EISSN 2149-4975
Turkish Journal of Cardiovascular Nursing - Turk J Card Nur: 16 (39)
Volume: 16  Issue: 39 - April 2025
RESEARCH ARTICLE
1. Determining the Relationship Between Healthy Lifestyle Behaviors and Cardiometabolic Risk Among Food and Beverage Sector Workers
Zeynep Demirezen Vidinlioğullari, Handan Sezgin
doi: 10.5543/khd.2024.38243  Pages 1 - 11
Objective: This study aimed to determine the relationship between healthy lifestyle behaviors and cardiometabolic risk among food and beverage industry workers.

Method: This descriptive and correlational study included 324 employees from 37 companies in Famagusta. No sampling method was used, and the study was completed with 161 participants. Data were collected using the Healthy Lifestyle Behavior Scale II (HLBS-II), the Type 2 Diabetes Risk Test (T2DRS), and the Framingham Risk Score (FRS). Statistical significance was set at P < 0.05.

Results: The participants had an average age of 31.27±10.31 years, 70.81% were male, and the mean HLBS-II score was above average (135.25±23.56). Of the participants, 10.35% had a moderate-to-high risk of cardiovascular disease, and 14.29% had a high T2DRS score. No significant correlation was found between HLBS-II scores and FRS or T2DRS. Participants with higher incomes, those who exercised regularly, and those with a family history of chronic diseases had higher HLBS-II scores, while smokers had higher FRS scores (P < 0.05). Factors such as age, marital status, years of employment in the sector, exercise habits, and a history of chronic disease were associated with an increased risk of diabetes (P < 0.05).

Conclusion: The study found that participants had above-average healthy lifestyle behaviors. However, despite the relatively young average age, 10.35% of the participants had an intermediate or higher 10-year cardiovascular risk, and 14.29% had a high risk of type 2 diabetes. It is recommended that nurses, in collaboration with workplace owners, provide counseling to employees on maintaining healthy lifestyle behaviors, cardiometabolic risk assessment, and awareness.

2. Psychological Resilience of Turkish Heart Failure Patients: The Role of Psychiatric Drugs, Stage of Heart Failure, and Type D Personality
Büşra Nur Çelik, Nevin Günaydın
doi: 10.5543/khd.2024.46034  Pages 12 - 20
Objective: This study aimed to identify the disease-specific factors (degree of heart failure) and psychological variables (type D personality, psychiatric drug use) that influence the psychological resilience of patients with heart failure.

Methods: Using a full-count sampling method, this cross-sectional survey was conducted among 157 Turkish patients with heart failure (57.3% male; mean age 71.7±11.86). Data were collected on personal information, the Type D Scale-14, and the Brief Resilience Scale.

Results: Approximately 68.2% of patients exhibited negative affectivity, and 37.6% demonstrated social introversion. Additionally, 36.3% and 27.4% were classified as having heart failure stages 2 and 3, respectively. Patients with heart failure had a mean resilience score of 18.2±6.6 out of 30. Regression analysis revealed that marital status, living arrangements, economic status, psychiatric drug use, and heart failure stage significantly influenced psychological resilience. Furthermore, negative affectivity and social introversion negatively impacted resilience.

Conclusion: This study found that the psychological resilience of heart failure patients was most significantly affected by the severity of heart failure (Class 3 and Class 4), negative affectivity (a sub-dimension of type D personality), and psychiatric drug use, which was also closely associated with negative affectivity. A decrease in psychological resilience corresponded with an increase in heart failure severity.

3. How Important is Acupressure Application in Balancing Heart Rate and Blood Pressure in the Treatment of Atrial Fibrillation? Randomized Controlled Study
Ayşe Soylu, Medet Korkmaz
doi: 10.5543/khd.2024.96658  Pages 21 - 30
Objective: Atrial fibrillation (AF) is a significant cause of morbidity and mortality due to complications such as elevated heart rate, embolism risk, and arrhythmia. This study aimed to assess the effect of acupressure on blood pressure and heart rate in patients diagnosed with chronic atrial fibrillation.

Methods: This randomized, placebo-controlled experimental study included 69 participants divided into three groups of 23 individuals, determined through power analysis. The research was conducted between February 20, 2018, and July 20, 2018. No interventions were applied to the control group before or after measurements. In the placebo group, an acupressure wristband was loosely placed in an inverted position on the Shenmen points (HT7) of the wrist, with no pressure applied. In the intervention group, acupressure wristbands were correctly positioned on both wrists to apply pressure to the Shenmen (HT7) points, and acupressure was administered. The intervention was conducted twice on the same day, at 9: 00 AM and 3: 00 PM.

Results: Comparison between the groups revealed no significant differences in blood pressure or heart rate following acupressure application in the experimental group (p > 0.05).

Conclusion: Acupressure applied to patients with chronic AF has no measurable effect on blood pressure or heart rate. Further studies involving larger groups are recommended.

4. Bibliometric Analysis of Nursing Studies on Identifying and Reducing Cardiovascular Disease Risk
Ayşe Dağıstan Akgöz, Sude Gençtürk Eroğlu, Sebahat Gözüm
doi: 10.5543/khd.2024.99267  Pages 31 - 39
Objective: This bibliometric analysis aimed to identify and visualize trends in studies focused on determining and reducing cardiovascular disease (CVD) risk within the nursing field between 2014 and 2024.

Methods: Data were collected from the Web of Science Core Collection database between March and April 2024. The analysis was conducted using the VOSviewer program. The study examined trends in the number of published articles over the years, as well as author, country, and institution contributions, citation patterns, collaboration networks, journal and author co-citation analysis, and keyword usage.

Results: A total of 849 authors from 42 countries and 369 institutions contributed to 178 studies published in 113 journals during the ten-year period. The Journal of Cardiovascular Nursing had the highest number of published articles, while the American Journal of Public Health was the most cited journal. The top three countries contributing to these publications were the United States, the Netherlands, and Australia. The five most frequently used keywords were “cardiovascular disease,” “risk assessment,” “prevention,” “nursing,” and “hypertension.”

Conclusion: This bibliometric analysis shows that interest in research on determining and reducing cardiovascular disease risk in nursing has grown in recent years. Meta-analyses and systematic reviews serve as key reference materials. The findings highlight the importance of addressing risk factors and suggest that studies in this field should increase citations to nursing journals. The analysis also indicates that developed countries with high disease burdens are leading research efforts in this area.

5. Investigation of Depression Levels, Self-Efficacy, and Self-Care Ability in Hypertensive Patients
Yağmur Başol, Zülfünaz Özer
doi: 10.5543/khd.2024.91885  Pages 40 - 48
Objective: This study aimed to examine depression levels, self-efficacy, and self-care ability among hypertensive patients.

Methods: A descriptive, cross-sectional, and exploratory design was used, involving patients diagnosed with hypertension who attended internal medicine and cardiology clinics at an educational and research hospital in Istanbul between October and December 2022. Data were collected through face-to-face interviews using the Introductory Information Form, Patient Health Questionnaire-9 (PHQ-9), Hypertension Self-Efficacy Scale (HSE Scale), and Self-Care Ability Scale (SCA Scale).

Results: The mean age of the patients was 64.11±12.46 years, and the average duration since diagnosis was 10.54±8.55 years. Among the participants, 59.1% were male, 72.2% were married, 55.6% were primary school graduates, 82.2% were unemployed, 56.1% reported income equal to expenses, and 85.2% lived with their spouse and children. Additionally, 42.9% of patients were overweight according to BMI, 85.5% took their medication regularly, 65.2% engaged in physical exercise, 62.9% had other chronic diseases, and 54.9% reported moderate general health status. The mean PHQ-9 score was 7.23±2.71, indicating mild depression risk. The mean scores for the HSE Scale and SCA Scale were 53.44±6.63 and 78.55±24.26, respectively. A significant negative correlation was observed between PHQ-9 and SCA Scale scores (r=-0.186, P < 0.01), while a significant positive correlation was found between the HSE Scale and SCA Scale scores (r=0.599, P < 0.01).

Conclusion: The findings indicate that hypertensive patients in this study had mild depression risk and moderate levels of both self-efficacy and self-care ability in managing their condition. Higher depression levels were associated with lower self-care ability, whereas greater self-efficacy was linked to improved self-care.

6. Perceived Social Support and Health-Related Quality of Life in Coronary Artery Patients: The Role of Death Anxiety
Ayşe Sena Okur, Ahmet Pınar, Zülfünaz Özer
doi: 10.5543/khd.2024.97752  Pages 49 - 56
Aim: This study examined the effects of death anxiety on social support and quality of life in patients with coronary artery disease.

Method: The study was conducted with 217 in-patients who were hospitalized in cardiology clinics between March 13 and June 30, 2023, in a training and research hospital in Istanbul. The data were collected with “Patient Information Form, Arabic Scale of Death Anxiety (ASDA), Multidimensional Scale of Perceived Social Support (MSPSS) and MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNewHRQL)”.

Results: Total mean ASDA score of the patients was 45.87 ± 11.13, mean MSPSS score of the patients was 64.9 ± 11.68, and mean MacNewHRQL score of the patients was 4.62 ± 0.75. Total mean scores of sub-dimensions were found as 4.49 ± 0.67 for emotional score, 4.72 ± 0.97 for physical score and 4.9 ± 0.98 for social score. Significant negative correlation was found between Fear Related to Physical and Mental Pain Associated with Death, Fear Related to the Dying Process Itself and ASDA and MacNewHRQL and sub-dimensions. Significant negative correlation was also found between Fear Related to Other Situations Reminding Death and support from family, support from significant others, MSPSS, MacNewHRQL and sub-dimensions.

Conclusion: Death anxiety and quality of life levels of the patients were found to be moderate, and their perception of social support was found to be high. Increasing death anxiety levels of the patients affect the quality of life negatively.

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