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International Journal of Cardiovascular Nursing

The International Journal of Cardiovascular Nursing is a Peer reviewed Journal providing users with recent Advancements in the field of Cardiovascular Nursing, Case studies and Clinical Practice related to cardiovascular Conditions. The Journal covers both theoretical and practical Aspects of Nursing and Cardiovascular care.

Focus and Scope of the Journal ! Physiological factors in Heart disease ! Women and cardiovascular Disease ! Acute Coronary Syndrome ! Physiologic, Psycologic and Social needs of Cardiovascular Patients ! Clinical Reviews ! Epidemiology and Physiology ! Cardiac Rehabilitation ! Drug Therapy and Clinical Trials

International Journal of Cardiovascular Nursing is published twice a year (bi-annual) by JournalsPub an imprint of Dhruv Infosystems Pvt. Ltd., India. The outlooks stated in the articles do not essentially reflect of the publisher. The publisher does not endorse the quality or value of the advertised/sponsored products described therein. Please consult full prescribing information before issuing a prescription for any products mentioned in this publication. No part of this publication may be reproduced, stored in retrieval or transmitted in any form without written permission to the publisher. To cite any of the material contained in this journal, in English or translation, please use the full English reference at the beginning of each article. To reuse any of the material, please contact JournalsPub (info@journalspub.com).

PUBLICATION MANAGEMENT TEAM

Chairman Mr. Puneet Mehrotra Managing Director, JournalsPub, New Delhi

INTERNAL MEMBERS

Associate Manager Hidam Renubala

Commissioning Editors Ankita Singh

Priyanka Garg

Akanksha Marwah

Chhavi Goel

Deepika Bhadauria

Shrawani Verma

EDITORIAL BOARD MEMBERS Dr. Sukhpal Kaur Lecturer, National Institute of Nursing Education, PGIMER, Chandigarh, India.

Dr. Sutapa Agrawal Epidemiologist, South Asia Network for Chronic Disease, Public Health Foundation of India Gurgaon (Haryana), India.

Dr. Gowrishankar Potturi Lecturer in Allied sciences, Allianze College of Medical sciences, Malaysia.

Mr. Nitin Nayyar Public Health Services & District Hospitals, National Health Mission, Delhi State Health Mission, New Delhi, India.

Dharitri Swain Department of Nursing, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Sijua, Odisha, India.

Simranjeet Kaur Cardiovascular and Thoracic Nursing, Lecturer, Manipal University, Karnataka, India.

Mr. N.J. Vasudevan Associate Professor, Chitra College of Nursing, Kerala, India.

Mr. Anil Sharma Joint Secretary, NRSI (Nursing Research Society of India), Associate Professor cum I/C Principal, Manikaka Topawala Institute of Nursing, CHARUSAT- Changa & Charotar University of Science and technology, Changa.

Dr. Harmeet Kaur Principal, Chitkara School of Health Sciences, Chitkara University, Punjab, India.

Dr. C. Kanniammal Principal, Meenakshi College of Nursing, Mangadu, Chennai, 600069, MAHER, (Meenakshi University), India.

Dr. Bimla Rani Vice Principal, Mai Bhago College of Nursing, Punjab, India.

Ms. Kripa Angeline A. Associate Professor, Kasturba Gandhi Nursing College, Puducherry, India.

Mr. Vijay V R Demonstrator, Government College of Nursing, UP RIMS&R, UP, India.

Mr. Sembian. N. Associate Professor, Government Nursing College, U.P. Rural Institute of Medical Sciences & Research, Saifai, Etawah.

Dr. B. Tamilarasi Principal, Madha College of Nursing, Chennai, India

From the Editor's Desk Dear Readers, We would like to present, with great pleasure, the Second Volume of a new scholarly journal, International Journal of Cardiovascular Nursing. This journal is part of the Applied Sciences, and is devoted to the scope of present nursing issues, from theoretical aspects to application-dependent studies and the validation of emerging technologies. This new journal was planned and established to represent the growing needs of Cardiovascular Nursing as an emerging and increasingly vital field, now widely recognized as an integral part of scientific and technical investigations. Its mission is to become a voice of the Nursing Science community, addressing researchers and practitioners in this area. The core vision of International journal of Cardiovascular Nursing in JournalsPub is to propagate novel awareness and know-how for the profit of mankind ranging from the academic and professional research societies to industry practitioners in a range of topics in Plant Nursing in general. JournalsPub acts as a pathfinder for the scientific community to published their papers at excellently, well-time & successfully. International Journal of Cardiovascular Nursing focuses on original high-quality research in the realm of Physiological factors in Heart disease, Women and cardiovascular Disease, Acute Coronary Syndrome; Physiologic, Psychological and Social needs of Cardiovascular Patients, Clinical Reviews, Epidemiology and Physiology, Cardiac Rehabilitation, Drug Therapy and Clinical Trials.. The Journal is intended as a forum for practitioners and researchers to share the techniques of Nursing and solutions in the area. Many scientists and researchers have contributed to the creation and the success of the Nursing community. We are very thankful to everybody within that community who supported the idea of creating an innovative platform. We are certain that this very first issue will be followed by many others, reporting new developments in the field of Nursing. This issue would not have been possible without the great support of the Editorial Board members, and we would like to express our sincere thanks to all of them. We would also like to express our gratitude to the editorial staff of JournalsPub, who supported us at every stage of the project. It is our hope that this fine collection of articles will be a valuable resource for Nursing readers and will stimulate further research into the vibrant area of Nursing. Puneet Mehrotra Managing Director

Contents 1. A Study to Assess the Effect of Sitting With Feet Flat on the Floor Vs Sitting With Cross Leg Position on Blood Pressure Reading Among Hypertensive and Normotensive Subjects in Selected Hospital of Delhi Kusum Roy, Bindu Shaiju, Eke Lama Tamang

2. Effect of Structured Teaching Program (STP) on Knowledge Regarding Cardiotocography (CTG) Monitoring Among Nursing Students S. Kumbhakar, V.R. Vijay

3. A Study to Evaluate the Effectiveness of Self Instructional Module on Knowledge of Care Givers of Stroke Patients Regarding the Stroke Rehabilitation at Selected Hospital in Amritsar, Punjab Amandeep Kaur, Manpreet Kaur Garcha, Jicy Shahji 17 4. A Study to Evaluate the Effectiveness of Video-Assisted Technique on the Knowledge of Preoperative Cardiac Patients Regarding Cardiac Rehabilitation in Selected Hospital at Amritsar Balwinder Kaur, Manpreet Kaur Garcha, Jicy Shahji

5. Association Between Cardiovascular Disease with Smokeless Tobacco Consumption and Smoking Archana Johnson

International Journal of Cardiovascular Nursing Vol. 2: Issue 1

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A Study to Assess the Effect of Sitting With Feet Flat on the Floor Vs Sitting With Cross Leg Position on Blood Pressure Reading Among Hypertensive and Normotensive Subjects in Selected Hospital of Delhi Kusum Roy*, Bindu Shaiju, Eke Lama Tamang Jamia Hamdard, New Delhi, India

Abstract Cardiovascular diseases are accepted as one of the leading cause of mortality and morbidity in developed and developing countries of the world. Risk of cardiovascular diseases depends upon blood pressure and co-existent factors. Hypertension is the most important risk factor for cardiovascular diseases. At any given time 15–20% of population is at risk with hypertension. Hypertension sometimes called a “silent killer” because people who have it are often symptom free. Diagnosis and treatment of various health care problems uses the most commonly available technique, which is, blood pressure monitoring, which is also an essential tool for determining the existence of hypertension. An experimental study with pretest-post-test-only design was used for the study. The study was conducted in ESI Hospital, Basaidarapur, New Delhi. The total population of the study consisted of normotensive and hypertensive patients visiting the outpatient department of ESI Hospital. Systematic random sampling was used for selecting 60 normotensive and 60 hypertensive subjects, in which 30 in experimental group and 30 in control group. Blood pressure of the subjects was assessed using aneroid sphygmomanometer. The significant findings of the study revealed that the mean systolic blood pressure of experimental group of normotensive adults i.e. 119.8 mm Hg was higher than control group of normotensive adults i.e. 115.8 mm Hg with mean difference 4.07 mm Hg with S.E.MD of 1.8 and t value of 2.16 which is greater than the table value (2.00) at df (58) at 0.05 level of significance. Mean diastolic blood pressure of experimental group post-test of normotensive adults i.e. 76.13 mm Hg was higher than control group post-test of normotensive adults i.e. 73 mm Hg with mean difference 3.10 mm Hg with S.E.MD of 1.4 and “t” value of 2.21 which is greater than the table value (2.00) at df (58) at 0.05 level of significance. The mean systolic blood pressure of experimental group of hypertensive adults i.e. 130.80 mm Hg was higher than control group of hypertensive adults i.e. 123.33 mm Hg with mean difference 7.47 mm Hg with S.E.MD of 2.8 and t value of 2.66 which is greater than the table value (2.00) at df (58) at 0.05 level of significance. The mean diastolic blood pressure of experimental group of hypertensive adults i.e. 81.46 mm Hg was higher than control group of hypertensive adults i.e. 76.71 mm Hg with mean difference 5.30 mm Hg with S.E.MD of 2.45 and t value of 2.16 which is greater than the table value (2.00) at df (58) at 0.05 level of significance. The mean systolic blood pressure of hypertensive subjects i.e. 130.8 mm Hg after intervention was higher than that of the normotensive subjects i.e. 119.8 mm Hg with t value of 4.55 which is greater than the table value (2.00) at df (58) at 0.05 level of significance. The mean diastolic blood pressure of hypertensive subjects i.e. 81.47 after intervention was higher than that of the normotensive subjects i.e. 76.13 with t value of 2.66 which is greater than the table value (2.00) at df (58) at 0.05 level of significance. The findings of the study suggest that sitting with cross leg at knee has an effect on both systolic and diastolic blood pressures of the normotensive and hypertensive adults, i.e. the crossing of legs increases the systolic and diastolic blood pressure of normotensive adults in sitting

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Effect of Structured Teaching Program (STP) on Knowledge Regarding Cardiotocography (CTG) Monitoring Among Nursing Students S. Kumbhakar, V.R. Vijay* Government College of Nursing, Uttar Pradesh Rural Institute of Medical Sciences and Research (UP RIMS& R), Saifai, Etawah, Uttar Pradesh, India

Abstract Labour is considered as one of the most memorable incidents of life period for each and every mother. The assessment of fetal well-being and mother is of paramount importance as far as labour is concerned, and here comes the role of cardiotocography (CTG) monitoring. Being future nurses, the students of nursing should have thorough knowledge and skill regarding CTG. The objective of the current study was to evaluate the effectiveness of STP on knowledge regarding CTG monitoring and to find out the association between the selected demographic variables and their knowledge score. A pre experimental one group pre- and post-test research design was employed. Fifty pre final year BSc nursing students of Vivekananda College of Nursing were included in the study. Subjects were prearranged on the basis of total enumeration sampling technique. Interview schedule was used to collect socio demographic data whereas questionnaire was used to assess knowledge of the subjects. The results revealed that the STP was statistically effective in improving the knowledge score with a mean post-test knowledge score of 15.14 as compared to the mean pre-test score of 6.68 (t value = 19.56, P < 0.01). To conclude, the enhancement of knowledge Score, 15.14 indicates that STP was efficacious in improving the knowledge of pre final BSc nursing students regarding CTG monitoring. Keywords: cardiotocography, nursing students, structured teaching program

INTRODUCTION Care given during the intrapartum period is the cornerstone of midwifery practice which would help women both physically and emotionally (NICE, 2012).[1] Fetal heart monitoring (FHM) during labour gives an impression of the fetal wellbeing or fetal compromise, thereby promoting the newborn's health status after birth. Cardiotocography (CTG) monitoring is a routine procedure that is used for the analysis of fetal state. Cardio signifies heart rate and toco, derived from Greek, refers to uterine activity. This is a common procedure that is being used in clinics and hospitals as well as at physicians’ offices,

to find out the association between fetal heart rate (FHR) patterns and uterine contraction.[2] This procedure is based on the non-invasive recording of FHR, maternal uterine contractions and fetal movement activity. Detection of the risks involved with the fetus at an early stage can help avoid critical situations which could prove to be more difficult or even impossible to manage in the newborn. Although, perinatal death has decreased from 4.6 million in 1990 to 3.3 million in 2010, the major causes of perinatal

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A Study to Evaluate the Effectiveness of Self Instructional Module on Knowledge of Care Givers of Stroke Patients Regarding the Stroke Rehabilitation at Selected Hospital in Amritsar, Punjab Amandeep Kaur, Manpreet Kaur Garcha*, Jicy Shahji Mai Bhago College of Nursing, Punjab, India

Abstract The human nervous system is one of the smallest and yet the most complex of the 11 body systems. It consists of both central nervous system including brain and spinal cord and peripheral nervous system.1 The brain receives about 25% of the body’s oxygen, but it cannot store it. Therefore blood needs to be supplied continuously. Reduction of or disruption in blood flow to the brain can result in a stroke. It is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain caused by a blocked or ruptured blood vessel.2 The aim of the study rehabilitation is to enable and experienced stroke to reach the highest possible. The study design is the quasi experimental two group experimental and control group. Sample will be taken for selected hospital by convenient sampling technique, Conclusion and discussion will be made according to findings of the study and comparing the results of present study with the previous literature. This present study is quasi experimental in nature in which with the help of structure teaching program, through which we can spread knowledge and awareness in the care givers of stroke patients about the stroke rehabilitation. The sample size for the study will be consisting of 100 samples in selected hospital of Amritsar. Pretest and posttest will be done to assess the knowledge of the care givers of stroke patients regarding the stroke rehabilitation. Methodology: A quasi experimental research study with research design of two group pretest and posttest with experimental and control group (Non randomization). The sample size for the study was consisting of 100 patients in Fortis escorts hospitals of Amritsar. Samples were selected with purposive sampling technique. Structured interview questionnaire tool was used for the collection of data. Results: The results of the study showed that there was significant difference in the mean posttest scores in knowledge. The finding reveals in experimental group of knowledge mean score of pretest and posttest of knowledge of the care givers of stroke Patients regarding the stroke rehabilitation is mean score of pretest and posttest of knowledge of the care givers of stroke patients regarding the stroke rehabilitation was 12.44 (SD ± 3.955) and 14.38. (SD ± 3.891) respectively. Posttest mean score was higher than the pretest mean score the “t” test value was 0.2324 which was significant at 0.05 level. In control group mean score of pretest and posttest of knowledge of the care givers of stroke patients regarding the stroke rehabilitation was 11.76 (SD± 2.337) and 12.36 (SD±3.094) respectively. Posttest mean scores and pretest mean scores almost same. The t-test value was 1.744 which was not significant at 0.05 level of significance. Keywords: care givers, knowledge, stroke patients, stroke rehabilitation, structured teaching

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A Study to Evaluate the Effectiveness of Video-Assisted Technique on the Knowledge of Preoperative Cardiac Patients Regarding Cardiac Rehabilitation in Selected Hospital at Amritsar Balwinder Kaur, Manpreet Kaur Garcha*, Jicy Shahji Mai Bhago College of Nursing, Punjab, India

Abstract Background: Cardiac disease worldwide with significant ethnic and regional variation and increasing morbidity and mortality as well as health care burden from myocardial infarction has been recognized latterly. Rehabilitation is important in terms of cost-effectiveness of cardiac care and rehabilitation. Cardiac rehabilitation aims to reverse limitations experienced by patients who have suffered the adverse pathophysiologic and psychological consequences of cardiac event. This present study is quasi experimental in nature in which with the help of video assisted teaching program knowledge and awareness was created in the pre-operative cardiac patients about the cardiac rehabilitation. The sample size for the present study was consisted of 100 samples from selected hospital of Amritsar. Pretest and posttest was done to assess the knowledge of pre-operative cardiac patients regarding the cardiac rehabilitation. Methodology: A quasi experimental research study with two group’s pre-test and post-test research design with (Non randomization) was used. The sample size for the study was consisting of 100 preoperative cardiac patients admitted in Fortis escorts hospitals of Amritsar. Samples were selected with purposive sampling technique. Structured interview schedule was used to collect data by using multiple choice questionnaires. Results: The results of the study showed that there was significant difference in the mean pretest & posttest knowledge scores. The finding reveals that in experimental group knowledge pretest and posttest mean score of the pre-operative cardiac patients regarding the cardiac rehabilitation was 12.80 (SD ± 3.534) and 22.16 (SD ± 3.633), respectively. Posttest mean score was higher than the pretest mean score the t-test value was 12.331 which was significant at 0.05 level. In control group mean score of pretest and posttest of knowledge of the pre-operative cardiac patients regarding the cardiac rehabilitation was 9.78 (SD± 1.799) and 10.30 (SD ± 1.515), respectively. Posttest mean scores and pretest mean scores almost same. The t-test value was 1.905 which was not significant at 0.05 level. Keywords: care givers, knowledge, structure teaching, stroke patients and stroke rehabilitation

INTRODUCTION Heart is a roughly of cone shaped hallow muscular organ. It is about 10cm long and it is about the size of the owner ‘fist. Heart is a hallow muscular organ which

functions through out of life. As it is a vital organ it is more susceptible for the diseases leading to malfunction causing severe complications for human life. Heart

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Association between Cardiovascular Disease with Smokeless Tobacco Consumption and Smoking Archana Johnson* SriRam Group of Colleges, Gwalior, MP, India

Abstract This article surveys the study of cardiovascular diseases (CVD) caused due to smoking and the ways by which tobacco smoke is thought to bring about CVD. Cigarette smoking is a main reason for CVD, and past reports have also validated the same. Cigarette smoking has been the cause for around 140,000 unexpected deaths yearly from CVD. More than 1 in 10 deaths worldwide occur due to CVD. Cigarette smoking additionally impacts other cardiovascular risks, for example, glucose intolerance and low serum levels of high-density lipoprotein cholesterol (HDLc). These risks are also exposed to people who are passively exposed to the smoke, thereby putting them also at a risk for CVDs. Keywords: cardiovascular disease (CVD) risk, smoking, smokeless tobacco, tobacco chewing

INTRODUCTION Coronary heart disease is a major root cause of deaths in the United States. In spite of open observation, smoking-caused coronary disease really brings about a larger number of deaths every year than smoking-induced cancer. Thirty percent of all coronary disease deaths are due to by cigarette smoking. Smoking is the single biggest preventable reason for coronary disease in the United States. India is stands second throughout the world, in tobacco consumption.[1-5] Tobacco smoke contains large amounts of carbon monoxide. Carbon monoxide influences the heart by decreasing the amount of oxygen the blood can carry. [6-8] This implies the heart, lungs, mind, and other key organs don't generally get enough oxygen to perform their functions. In the meantime, nicotine causes an expansion in heart rate and pulse.[5,9-11] After some time, this causes remarkable

"wear and tear" on the cardiovascular system. Individuals who use tobacco will probably have heart attacks, hypertension, blood clumps, strokes, hemorrhages, aneurysms, and different disorders of the cardiovascular system.[13-15] Smoking multiplies the danger of dying from coronary cardiovascular disease. Cigarette smoking is a major reason for stroke by increasing the presence of clotting factors in blood, reducing HDL cholesterol levels, expanding triglyceride levels, and destroying the blood vessellining. The risk for stroke increases as the number of cigarettes smoked increases.[11,16] The utilization of smokeless tobacco among grown-up guys in India is as high as 32.9% and for females it is 18.4%. A few studies have demonstrated that the present utilization of smokeless tobacco in never smoking men is connected with

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