الفهرس 
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Abstract
Introduction:
Coronary heart disease is one of the most common causes of death worldwide. In 2012, ischaemic heart disease accounted for 7.4 million deaths worldwide. CHD is caused by impaired blood flow to the myocardium .Accumulation of atherosclerotic plaque in the coronary arteries is the usual cause. Coronary heart disease may be asymptomatic, or may lead to angina pectoris, acute coronary syndrome, myocardial infarction (MI or heart attack), dysrhythmias, heart failure, and even sudden death (Lemone, et al., 2015; Yinko, et al., 2014).
Outcomes continue to be one of the most powerful measures of quality care in all health care settings for all caregivers. Nurse-sensitive outcome measurement is one of the most promising strategies that can enhance patient care and satisfaction of patients, families, and caregivers (Idemoto and Kresevic, 2013). This emphasis on identifying and measuring the results of interventions and practice is noteworthy and necessary and has important implications for cardiovascular nursing practice as the patient outcomes is the ultimate definition of effectiveness and efficiency (Lundy, 2014).
Nursing care is a key factor in the outcomes of hospitalized patients, the nurse develops a list of nursing interventions (actions) and client outcomes to promote healthy responses and to prevent, reverse, or decrease unhealthy responses. Outcomes, which are mutually established by client and nurse, identify what the client will be able to do as a result of nursing interventions. Outcome criteria for nursing diagnoses are client centered, time specific, and measurable. They are classified into three domains: cognitive (knowing), affective (feeling), and psychomotor (doing). The nurse considers all three domains to ensure holistic care (Lemone, et al., 2015).
Aim of the study: -
- Identify factors affecting patients’ outcomes after acute coronary syndrome.
Research questions
-To achieve the aim of this study the following research question was be formulated:
What are the factors that affect biopsychosocial outcomes for patients with acute coronary syndrome?
Subject and methods:
Research design: A descriptive exploratory design was utilized to meet the aim of the study
Setting: The study was conducted in the Coronary Care Units (CCUs) at Ain Shames University hospital.
Subjects: A Purposive sample of 100 patients was recruited in this study.
Inclusion Criteria:
Adult patient over 18 years diagnosed with recently acute coronary syndrome.
Exclusion Criteria:
Mentally, psychiatric, and patient with mechanical ventilated.
Study tools:-
It included the following parts
I-patients’ Interview questionnaire:
This tool was included the three following parts:
1-Sociodemographic data:
It aimed to assess (age, sex, occupation, marital status, level of education and socioeconomic status as number of family members, housing condition, and income per month per persons).
2-Patient health history:
It was be used to collect data about patient history which include (present, and past health history).
3- Assessment of Family risk factors:
It was be used to collect data about family history regarding to heart disease, obesity, hypertension, hyperglycemia, hypercholesterolemia, and others disease.
II-Patients outcomes assessment tool:
This tool was be used to assess biopsychosocial outcomes of the patients with ACS. It was included all patients outcomes related to biopsychosocial and perceived (spiritual) aspects.
The present study revealed that:
Regarding gender, the results revealed that (63%) of the studied patients were males. As regards to age (40%) of studied patients age ranged from (50≤60) years old. (51%) of the studied patients suffering from Acute myocardial infarction with st elevation and (37%) of the patients had diabetes mellitus and hypertension. It reveals that highly statistically significant relation between physiological, psychological, and social health total outcomes with work status, age, educational level and monthly income (p < 0.001). It reveals that highly statistically significant relation between physiological health total outcomes and present, past illness (p < 0.01), while statistically significant relation with psychological and social health total outcomes (p < 0.05) and present, past illness.
Conclusions:
The present study revealed that the factors affecting patients’ outcomes with ACS were age, educational level, work status, monthly income, present history and past history of the patients under study. In addition to, there was strong correlation between physiological, psychological and social health outcomes.