Minimum education level of junior high school (third year) Īnxiety score of > 42 and sleep quality score of > 5 Ĭonditions intervening with normal sleep, such as night work, having a baby, and having a spouse who worked at night In total, 20 subjects were selected via convenience and purposive sampling from 60 individuals based on the inclusion and exclusion criteria.Ĭardiac surgery within the past six months This quasi-experimental study was conducted on patients with CHF following CABG at Imam Ali Heart Hospital in Kermanshah, Iran in 2019. Therefore, problem-solving styles are considered to be important tools for the management of issues such as anxiety and sleep disturbance ( 8).Ĭonsidering the adverse effects of sleep disturbances on the QOL and the negative consequences in CHF patients, the high prevalence of anxiety that leads to sleep disturbance in these patients, the role of problem-solving skills training (PSST), and lack of similar research in this regard, the present study aimed to assess the effects of PSST on the sleep quality and anxiety of patients with CHF following CABG surgery in Kermanshah, Iran. On the other hand, problem-solving style refers to the cognitive and behavioral activities through which an individual strives to gain an accurate understanding of their daily life affairs and find effective coping strategies and solutions. Problem-solving orientation is a cognitive process that acts as the motivational use of problem-solving and encompasses relatively stable cognitive-emotional schemas, which reflect the general beliefs and perceptions of humans toward life affairs. Researchers have marked high anxiety rates in cardiac patients, cautioning that lack of treatment may increase the risk of cardiac events ( 7).Īs part of cognitive science, problem-solving skills are recognized as an undeniable research priority and are mostly determined by two general, partially independent processes, known as problem-solving orientation and problem-solving style. Moreover, anxiety directly affects CAD patients and leads to the poor prognosis of CHF patients. Evidence attests to the direct correlation between anxiety and sleep quality. In addition, sleep disturbance was more prevalent in the patients with CAD compared to the healthy individuals, and factors such as respiratory disorders, aging, and medication were speculated to have adverse effects in this regard ( 6). In another research, 51%, 44%, 40%, and 39% of patients with coronary artery disease (CAD) were reported to have insomnia, sleep disturbance, problems in the last stage of sleep, and early waking ( 5). ( 4) reported that 74% of patients with congestive heart failure (CHF) experienced various types of sleep disturbance, and the stimulation of the autonomic nervous system caused hemodynamic, hormonal, neural, and cardiovascular changes in these patients. Therefore, sleep quality improvement and anxiety reduction positively influence the cardiac health and quality of life (QOL) of cardiac patients ( 3). The excessive activity of these systems has adverse effects on the cardiovascular system ( 2). A broad range of experimental and physiological data supports the association of cardiovascular diseases and psychological problems, demonstrating that an adaptive physiological mechanism is a response to anxiety and sleep disturbance, which allows the organism to fight the harmful stimuli, which in turn leads to the stimulation of the sympathoadrenal system and hypothalamic-pituitary-adrenal axis with the secretion of cortisol and norepinephrine. Statistics in Iran are indicative of the increased mortality rate due to cardiovascular disorders, with 317 and 116,000 confirmed deaths in Iran daily and annually, respectively ( 1). BackgroundĬardiovascular diseases are a leading cause of mortality in Iran and globally, imposing tens of millions of dollars on medical systems. Therefore, it is recommended that such training be provided to cardiac patients.Īnxiety Heart Disease Problem-solving Skills Sleep Quality 1. According to the results, PSST could improve anxiety and sleep quality in patients with heart failure.
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