Journal of Education and Health Promotion

Abstract BACKGROUND: Despite new anticoagulants’ developments, warfarin is still one of the most
commonly used medicines, particularly in the cardiovascular system. One of the significant challenges
with warfarin is the prevalence of dangerous side effects such as bleeding and drug and food
interactions, which can negatively affect patients if not adequately controlled. As health‑care team
members, nurses have a crucial role in prescribing this medicine and educating patients. In this
regard, this study was conducted to determine the knowledge and practice of nurses working in the
cardiovascular wards regarding warfarin.
MATERIALS AND METHODS: In this cross‑sectional, descriptive study, knowledge and practice
of 239 nurses working in the cardiovascular wards of teaching hospitals affiliated to Iran University
of Medical Sciences have been investigated using European Cardiovascular Nurses Knowledge
questionnaire on anticoagulants and the checklist for high‑risk drugs safety instructions. The sampling
was performed through the stratified sampling method with proportional allocation. Data were analyzed
using the SPSS software version 16 through descriptive and inferential statistics (independent t‑test,
one‑way analysis of variance, and Pearson correlation coefficient) (Inc., Chicago, IL, USA).
RESULTS: The mean scores of knowledge (18.51 ± 3.87) and practice (10.53 ± 2.12) were
slightly higher than the median, and the lowest mean score was related to knowledge on drug
interactions (7.62). The practice had a statistically significant relationship with knowledge (P ˂ 0.001).
Regarding demographic variables, there was a statistically significant relationship between nurses’
knowledge and the education level (P = 0.009) and nurses’ practice and age (P = 0.022), work
experience (P = 0.032), and work experience in cardiovascular wards (P = 0.036).
CONCLUSIONS: Based on the findings of this study, the knowledge of nurses working in the
cardiovascular wards about warfarin was not sufficient, and their practice was of poor quality. Nurses’
lack of knowledge and improper practice can jeopardize drug safety in patients and cause serious
side effects such as bleeding. Proper training of nursing students and nurses about warfarin as a
high‑risk drug, its side effects, and drug‑food interactions, and the emphasis on patient education in
patients receiving this medicine can effectively reduce the incidence of side effects.

Abstract INTRODUCTION: Chronic diseases leave a huge impact on the life of children and their family
caregivers (FCGs). Therefore, the present study was conducted to determine the effect of the
combination of Benson’s relaxation technique (BRT) and brief psycho‑educational intervention (BPI) on
religious coping (RCOPE), sense of coherence (SOC), and quality of life (QoL) of FCGs in children
with chronic disease.
MATERIALS AND METHODS: The study population, consisted of 100 FCGs whose children were
afflicted by chronic diseases, and participated in the current quasi‑experimental pretest posttest
design. The children were recruited from two state pediatric hospitals in Tehran, Iran. The RCOPE,
SOC, and QoL of FCGs were assessed twice, through pretest (T1) and posttest (T2), four weeks
after the intervention, by means of RCOPE, SOC and SF‑36 questionnaires. The FCGs participated
in four training sessions lasting up to 70 min over one week, followed by four more weeks of training.
The Chi‑square, Fisher’s exact tests, independent t‑test, and paired t‑test were performed.
RESULTS: Positive RCOPE had a significant rise at T2 (P = 0.020) compared with negative RCOPE
that did not show significant changes in T2. SOC scores for the intervention group remarkably rose
at T2 (P = 0.022); but, for the control group, the drop was marginal. The QoL scores of both physical
and mental components were statistically significant in the intervention group at T2 (P < 0.05).
CONCLUSION: Findings of the present study suggest that BRT and BPI can help significantly improve
the RCOPE, SOC, and QoL of families with children suffering from chronic diseases. Measures that
could enhance the RCOPE, SOC, and QoL include low‑cost interventions, good safety, and decent
outcome.

Abstract BACKGROUND: Total knee arthroplasty (TKA) can cause operational anxiety in patients. The
purpose of this study was to determine the effects of a hospital rehabilitation program on operational
anxiety in patients following TKA.
MATERIALS AND METHODS: A nonrandomized clinical trial was conducted on 96 patients who
were total knee replacement (TKR) candidates in Milad Hospital, Tehran, Iran. The participants
were allocated to two groups of control and experiment each with 48 participants. A rehabilitation
training program was implemented in the experimental group and the routine care program was
administered to the control group. The data collected through demographic form and Spielberger
anxiety questionnaire. The collected data were analyzed using Fisher’s exact test, covariance,
independent t‑test, and paired t‑test (P = 0.5).
RESULTS: The results of the paired t‑test indicated that the mean score of anxiety in both groups
was decreased. Independent t‑test showed that there was a significant difference between the two
groups in terms of the mean scores of anxiety so that it was significantly higher in the control group
compared to the experimental group (P < 0.001).
CONCLUSIONS: The implementation of the rehabilitation education by a rehab nurse can improve
the surgical outcomes in patients under TKR. Despite the positive results in this study, the results
should be interpreted and clinically used with caution given the small number of participants and the
specific circumstances of this study.