Effect of Liaison Nurse Service on Transfer Anxiety of Patients Transferred From the Cardiac Surgery Intensive Care Unit to the General Ward

Background: Transition from intensive care unit to a general ward is a stressful situation for patients. It is believed that a liaison nurse can prevent adverse events during the transfer process. Objectives: This study aimed to examine the effect of a liaison nurse on anxiety related to the transportation of patients from the cardiac surgery intensive care unit to a general ward. Methods: This randomized clinical trial was conducted on 68 patients that were randomly assigned to the experimental and control groups. The demographic information and disease profile were collected at the baseline of the study. Liaison nurse services were provided for the experimental group during the transfer process. The Spielberger state-trait anxiety inventory (STAI) was used to measure the patients’ anxiety at the start of the transfer and two hours after admission to the general ward. Independent samples and paired t-tests were used to compare the anxiety mean scores in the experimental and control groups. Results: Before the intervention, the mean anxiety was 45.61 ± 12.42 and 40.11 ± 10.95 in the experimental and the control groups, respectively (P = 0.057). However, after the intervention, the mean anxiety score was significantly decreased to 33.20 ± 6.22 in the experimental group (P < 0.001) while it increased to 44.17 ± 10.23 in the control group (P < 0.001). Conclusions: Liaison nurse services affected the patients’ anxiety in the process of transition from the cardiac surgery intensive care unit to the general ward

Self-monitoring by traffic light color coding versus usual care on outcomes of patients with heart failure reduced ejection fraction: Protocol for a randomized controlled trial

Background: Patients with heart failure (HF) reduced ejection fraction (HFrEF) have symptoms that are more severe and experience a higher rate of hospitalization compared with HF preserved ejection fraction (HFpEF) patients. However, symptom recognition cannot be made by patients based on current approaches. This problem is a barrier to effective self-care that needs to be improved by new self-monitoring instruments and strategies. Objective: This study describes a protocol for the self-monitoring daily diaries of weight and shortness of breath (SOB) based on the traffic light system (TLS). The primary objective is to compare the self-care between the intervention and control group. Comparison of HF knowledge, HF quality of life (HFQOL), and all-cause hospitalization between the 2 groups are the secondary objectives. Methods: A single-blind randomized controlled trial is being conducted at the HF clinic at Tehran Heart Center (Tehran, Iran). Sixty-eight adult patients of both genders will be enrolled during admission to HF clinic. Eligible subjects will be assigned to either the intervention or control group by a block balanced randomization method. Baseline surveys will be conducted before random allocation. Participants in the intervention group will receive an integrated package consisting of (1) HF self-care education by an Australian Heart Foundation booklet on HF, (2) regular home self-monitoring of weight and SOB, and (3) scheduled call follow-ups for 3 months. Patients in the control group will receive no intervention and they only complete monthly surveys. Results: This study is ongoing and is expected to be completed by the end of 2018. Conclusions: This is the first trial with new self-monitoring instruments in Iran as a low and middle-income country. If the findings show a positive effect, the package will be applied in different regions with the same health care status. ©Mahin Nomali, Ramin Mohammadrezaei, Abbas Ali Keshtkar, Gholamreza Roshandel, Shahrzad Ghiyasvandian, Kian Alipasandi, Masoumeh Zakerimoghadam