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  Background and Objective: surgery is a stressful experience and in open heart surgery, the patients are greatly faced with anxiety, which has been reduced by different approaches. This study aimed to investigate the effects of aromatherapy on anxiety level.

  

  Material and Methods: This blinded- randomized- controlled clinical trial was carried out on 90 patients divided into two groups of intervention and control. the patients of intervention group were asked to inhale two drops of lavender essential oil and those of control group two drops of distilled water poured on a gauze , for 20 minutes. In addition to measuring patients’ anxiety level by Spielberger questionnaire, we recorded their vital signs. Using SPSS 16 software, the data was described via mean, standard deviation and percent, and analyzed by using independent t-test, paired t-test, Chi Square and Covariance (0.05).

  

  Results: The mean age of intervention group was 50.49 ± 10.92 and control group was 50.13 ± 9.20. Anxiety score in intervention group was significantly decreased from 56.37±5.6 to 54.73±5.42 and in control group meaningfully reduced from 55.18±7.35 to 54.0±7.22 (p<0.05). The mean anxiety score in the intervention group was significantly higher than that of control group (p<0.05).

  

  Conclusion: Because anxiety reduction in aromatherapy group was more than control group it can be concluded that aromatherapy with lavender essential oil have significant effect in reducing anxiety and therefore can be used in clinical situations.

  

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  Background and Objective: After coronary artery bypass surgery, pulmonary complications and oxygenation disorders are common, which have an important role in disablement and mortality. Different methods are used for improvement of pulmonary function and oxygenation. In this study we aimed at evaluating the effect of deep breathing exercise on arterial blood gases after CABG.

  

  Material and methods: This clinical trial was conducted on fifty patients who had CABG in Chamran hospital and Sina heart center of Isfahan, 2012. The patients were randomly located in groups of intervention and control. The intervention was the use of deep breathing exercises initiated after extubation while just the routine breathing exercises were used for control group. Arterial blood gases of all patients were measured before surgery, after extubation, second and the third postoperative days, and analyzed by independent t test.

  

  Results: the arterial blood gases measured in before surgery, after extubation, first and second days were the same in intervention and control groups. In the third postoperative day, there was a significant difference in the mean of arterial blood oxygen (81.3±4.6 vs. 72.7±7.1 respectively, p=0.01), arterial blood carbon dioxide (37 ±1.9 vs. 43.7±3.2 respectively, p >0.001) and oxygen saturation (96.8±1/4 vs. 90.5±2.1 respectively, p >0.001).

  

  Conclusion : in terms of the results, the deep breathing exercise is significantly more effective in improvement of blood arterial gases parameters.

 

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  Background and Objective: ­ ­Delirium is a kind of fluctuating cognitive­ destruction , disorientation and ­a common problem for inpatients, which leads to increased mortality, prolonged hospital stay, increased cost and decreased rehabilitation.­ This study evaluates the incidence of delirium and its associated risk factors in open heart surgery.

  Material and Methods: This descriptive-analytical study was conducted ­­in six month (2011), via convenience sampling, on 404 patients undergoing elective cardiac surgery in the heart center of Fatemeh Zahra in Sari, Iran. Using Neecham questionnaire and demographic checklist, delirium was evaluated from the first till the fifth day of surgical operation. We used survival analysis (Kaplan-Meier and Cox regression) to­ analyze the findings, using SPSS software version18.
Results: The incidence of delirium is reported 28.5%. There is a significant relation between the incidence of delirium and variables such as age , lower education, rural, history of kidney failure, heart failure, stroke, hearing disorder, atrial fibrillation, increased serum potassium and increased serum urea.

  Conclusion: ­ According to the results, screening for d elirium is a matter of the utmost importance . With attention to individual profile and preoperative factors related to delirium, it is necessary to train elder and lower education patients, to maintain electrolyte balance before operation and to eliminate sensory deprivation in order to lessen the incidence of delirium.

 

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Background and objective: Coronary Bypass Graft Surgery (CBG) is one of the therapeutic approaches having the leading effects on the function of the patients. Because of paramount importance of self-efficacy and self-esteem, we aimed to evaluate the effectiveness of family-centered empowerment on the self- efficacy and self-esteem of the patients undergoing coronary bypass surgery.
 Material and Methods: This case control clinical trial was conducted on 102 patients with elective heart surgery and 102 of their active family members in 2011.‌ The patients were selected via convenience sampling and randomly assign ed to experimental and control group. After measuring the self-efficacy and self-esteem, family-centered empowerment care, including individual training, group discussion, film and active participation,‌ was performed in experimental and just routine care in control group. Using PASW statistics-18, we analyzed the data.
Results: The results showed that the two groups were the same considering population variables and the mean scores of self-efficacy and self-esteem. The level of self-efficacy and self-esteem in case group were significantly higher than those of controls (P<0.000). After intervention, the mean score of self-efficacy and self-esteem were increased (P<0.0000).
Conclusion:‌In regard with the results,‌ family-centered ‌empowerment care ‌in patients undergoing CBG is practically feasible , and it can be helpful in improving self-efficacy and self- esteem.

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Background and Objective: Fulfilling the needs of ICU patients' families plays a significant role in their satisfaction. Since having information is one of the most important needs, we aimed to investigate the effectiveness of family-center support in satisfaction of information among families of patients undergone open heart surgery.

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Background and Objective: The usual method of assessing depth of anesthesia, which is not sensitive and specific enough, is measuring hemodynamic parameters, autonomic changes and subjective symptoms including movement, sweating and lacrimation. This study aimed to determine the relationship between the depth of anesthesia and hemodynamic indices.

Material and Methods: This correlational study was conducted on 57 patients undergoing elective hernia surgery in Shahid Beheshti Hospital ,Sabzevar in summer 2014.  An identical anesthesia technique was used for all patients.  Depth of anesthesia was monitored quantitatively by bispectral index (BIS) at 5-minute intervals, with simultaneous recording of heart rate and blood pressure. We analyzed the data using Anova and correlation coefficient.

Results: The mean age was 45.54±13.46. The patients were males (n=36) and females (n= 21).   Only 59.6 % of the patients experienced a normal depth of anesthesia. Hemodynamic parameters were not significantly correlated with anesthetic depth except for heart rate in the first 5 minutes (P= 0.013).

Conclusion: Given that hemodynamic parameters have some limitations in determining the acceptable depth of anesthesia, we recommend using the monitors based on brain signal processing.

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Background and Objective: Anxiety is the most common psychological reaction of the families of the patients in cardiac surgery intensive care unit (CSICU). Since nursing consultation is an approach to controlling anxiety, we aimed to determine its effect on anxiety of the patients' families in CSICU.

Material and Methods: This clinical trial was conducted on fifty-four family members, of the patients in CSICU of a hospital in Kurdkoy, Iran, allocated into intervention and control groups. For intervention group, nursing consultation program was carried out from admission to discharge while for control group just routine was performed. The data was collected via a demographic checklist and state- anxiety Spielberger inventory, and analyzed by chi-square, independent and paired t-tests.

Results: The results showed that the two groups had similar demographic characteristics. Using independent t-test, their anxiety levels were not significantly different before intervention while they were after intervention. This means that nursing counseling was effective in reducing family's anxiety level (P<0.001). Based on paired t test, there was a significant difference between before and after anxiety in case group (P<0.01) but in control group the difference was not significant (p>0.01).

Conclusion: Nursing consultation can be helpful in mitigating in family's anxiety in cardiac Surgery intensive care unit.