Document Type : Original Article(s)


1 Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Cancer Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran

3 Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran


BACKGROUND: Cardiac problem causes changes in different aspects of life in patients, including their activities of daily living (ADL). Because of the important role of family in caring for patient after pacemaker implantation, this study was done to evaluate the effect of family-centered empowerment model on ADL of patient after pacemaker implantation.
METHODS: This randomized clinical trial study was performed on 70 patients who underwent pacemaker implantation in Shahid Chamran Hospital, Isfahan, Iran. Patients and their family in the intervention group received educational program according to family-based empowerment program. The control group only received routine interventions. Data were collected using a valid specific quality of life (QOL) questionnaire and analyzed by SPSS software.
RESULTS: Patient's self-efficacy, self-esteem, and personal QOL have been improved after the empowerment program compared with the baseline and the control group (P < 0.05 for all).
CONCLUSION: The QOL in patients with pacemaker is relatively low. Similar to previous studies, family-centered empowerment model, due to participation of the patients and their families in education, learning, and taking care of the patients, could be an appropriate model to implement.


  1. Mohammad Hasani MR, Farahani B, Zohour AR, Panahi Azar SH. Self-care ability based on Orem’s theory in individuals with coronary artery disease. Iran J Crit Care Nurs 2010; 3(2): 87-91. [In Persian].
  2. Yalfani A, Nazem F, Safiarian R, Jargeh M. The effects of exercise cardiac rehabilitation on anxiety, depression and quality of life in coronary artery bypass grafting patients. Avicenna J Clin Med 2012; 19(1): 39-44. [In Persian].
  3. Khodadadi E, Mohammadzadeh S, Hekmatpou D, Zohour A. A comparison between the effectiveness of pacemaker care education through compact disc and group education on nurses' knowledge and performance in educational hospitals of Arak University of Medical Sciences in 2012. Mod Care J 2013; 10(1): 10-8. [In Persian].
  4. Zipes DP, Libby P, Bonow RO, Mann DL, Braunwald E, Tomaselli GF. Braunwald's heart disease: A textbook of cardiovascular medicine. 11th Philadelphia, PA: Elsevier Science; 2018.
  5. Ellenbogen KA, Wood MA. Cardiac pacing and ICDs. 5th Hoboken, NJ: Wiley; 2008.
  6. Ali Akbari F, Khalifehzadeh A, Parvin N. The effect of short time telephone follow-up on physical conditions and quality of life in patients after pacemaker implantation. J Shahrekord Univ Med Sci 2009; 11(3): 23-8. [In Persian].
  7. Shahriari M, Jalalvandi F, Yousefi H, Tavakol K, Saneei H. The effect of a self-care program on the quality of life of patients with permanent pacemaker. Iran J Med Educ 2005; 5(1): 45-52. [In Persian].
  8. Greenspon AJ, Patel JD, Lau E, Ochoa JA, Frisch DR, Ho RT, et al. Trends in permanent pacemaker implantation in the United States from 1993 to 2009: Increasing complexity of patients and procedures. J Am Coll Cardiol 2012; 60(16): 1540-5.
  9. McMullan J, Valento M, Attari M, Venkat A. Care of the pacemaker/implantable cardioverter defibrillator patient in the ED. Am J Emerg Med 2007; 25(7): 812-22.
  10. Speedie A, Mathew C, Shahi RS, Calton R. Long-term mortality in patients with permanent pacemaker implantation. J Assoc Physicians India 2016; 64(9): 18-22.
  11. Udo EO, van Hemel NM, Zuithoff NP, Nijboer H, Taks W, Doevendans PA, et al. Long term quality-of-life in patients with bradycardia pacemaker implantation. Int J Cardiol 2013; 168(3): 2159-63.
  12. Figueroa C, Alcocer L, Ramos B. Psychological intervention to modify anxiety, depression and quality of life in patients with an implantable pacemaker. Psychology 2016; 7(3): 374-81.
  13. van Eck JW, van Hemel NM, van den Bos A, Taks W, Grobbee DE, Moons KG. Predictors of improved quality of life 1 year after pacemaker implantation. Am Heart J 2008; 156(3): 491-7.
  14. Jaarsma T, Halfens R, Tan F, Abu-Saad HH, Dracup K, Diederiks J. Self-care and quality of life in patients with advanced heart failure: The effect of a supportive educational intervention. Heart Lung 2000; 29(5): 319-30.
  15. Furuya RK, Mata LR, Veras VS, Appoloni AH, Dantas RA, Silveira RC, et al. Original research: telephone follow-up for patients after myocardial revascularization: A systematic review. Am J Nurs 2013; 113(5): 28-31.
  16. Ghotbi N, Seyed Bagher Maddah S, Dalvandi A, Arsalani N, Farzi M. The effect of education of self care behaviors based on family-centered empowerment model in type II diabetes. Advances in Nursing and Midwifery 2014; 23(83): 35-42.
  17. Pedram Razi S, Sadeghi M, Nikbakht Nasrabadi AR, Ebrahimi H, Kazemnejad A. The effect of family-centered empowerment model on knowledge and metabolic control of patients with type 2 diabetes. Knowledge Health 2014; 9(1): 48-54. [In Persian].
  18. Buhse M. Assessment of caregiver burden in families of persons with multiple sclerosis. J Neurosci Nurs 2008; 40(1): 25-31.
  19. Zarei AR, Jahanpour F, Alhani F, Razazan N, Ostovar A. The impact of multimedia education on knowledge and self-efficacy among parents of children with asthma: A randomized clinical trial. J Caring Sci 2014; 3(3): 185-92.
  20. Zafar ramzanian Z, Alhani F, Anoosheh M. The effect of Family Centered Empowerment Model on mothers’ QOL of girls under six years old with UTI. J Health Promot Manag 2014; 3(3): 7-15. [In Peesian].
  21. Rajabi R, Mahmoudirad G, Sabzevari SS, Borhani F, Faramarzpor M. The effect of family-centered empowerment model on quality of life among mothers of asthmatic children. Mod Care J 2016; 13(1): e960.
  22. Saffari M, Sanaeinasab H, Rshidi Jahan H, Purtaghi Ghh, Pakpour A. Happiness, self-efficacy and academic achievement among students of Baqiyatallah University of Medical Sciences. J Med Educ Dev 2014; 7(13): 22-9. [In Persian].
  23. Vala M, Razmandeh R, Rambol K, Nasli Esfahani E, Ghodsi Ghasemabadi R. Mindfulness-based stress reduction group training on depression, anxiety, stress, self-confidence and hemoglobin a1c in young women with type 2 diabetes. Iran J Endocrinol Metab 2016; 17(5): 382-90. [In Persian].
  24. Wahlin I, Ek AC, Idvall E. Empowerment from the perspective of next of kin in intensive care. J Clin Nurs 2009; 18(18): 2580-7.
  25. Wichit N, Mnatzaganian G, Courtney M, Schulz P, Johnson M. Randomized controlled trial of a family-oriented self-management program to improve self-efficacy, glycemic control and quality of life among Thai individuals with Type 2 diabetes. Diabetes Res Clin Pract 2017; 123: 37-48.
  26. Schrag A, Hovris A, Morley D, Quinn N, Jahanshahi M. Caregiver-burden in Parkinson's disease is closely associated with psychiatric symptoms, falls, and disability. Parkinsonism Relat Disord 2006; 12(1): 35-41.
  27. Ataee E, Haghjoo M, Dalvandi a, Bakhshandeh H. Effect of self-care education on quality of life among patients with permanent pacemaker. Iranian Journal of Cardiovascular Nursing 2013; 1(4): 40-7. [In Persian].
  28. Sanaie N, Nejati S, Zolfaghari M, Alhani F, Kazemnezhad A. The effects of family-based empowerment on family cooperation in following patient treatment regime after coroner arteries bypass surgery. Mod Care J 2014; 11(1): 19-27. [In Persian].
  29. Davarpanah M, Fayazi S, Shariati A, Mirhosseini S D. The effect of family-centered empowerment model on the quality of life of patients with leukemia. Jundishapur J Chronic Dis Care 2017; 6(1): e36441.