Journal of Hayat
حیات
Hayat
Medical Sciences
http://hayat.tums.ac.ir
1
admin
1735-2215
2008-188X
fa
jalali
1402
10
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gregorian
2024
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29
4
online
1
fulltext
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تأثیر توانبخشی قلبی پرستار هدایتگر در منزل بر تبعیت از درمان بیماران مبتلا به انفارکتوس میوکارد: یک کارآزمایی بالینی تصادفی شده
The effect of nurse-led home-based cardiac rehabilitation on adherence to therapeutic regimens in patients with myocardial infarction: A randomized clinical trial
مراقبتهاي پرستاري
Nursing Care
پژوهشي
Research
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">زمینه و هدف: </span></span></span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">عمده­ترین نیاز مراقبتی بیماران مبتلا به انفارکتوس میوکارد، مراقبت مستمر است و این موضوع از چالش­های مهم مراقبت پرستاری نیز هست. بنابراین مطالعه حاضر با هدف تعیین تأثیر توانبخشی قلبی پرستار هدایتگر در منزل بر تبعیت از درمان بیماران مبتلا به انفارکتوس میوکارد انجام گرفته است</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">.</span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.1pt">روش بررسی:</span></span></span></span></i></b><i> </i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">در این </span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">مطالعه کارآزمایی بالینی تصادفی شده تعداد 80 نفر از بیماران واجد شرایط به طور در دسترس از بیمارستان­های منتخب دانشگاه علوم پزشکی تهران در سال 1400-1399 انتخاب و سپس به روش تصادفی بلوکی به دو گروه مداخله و کنترل تخصیص داده شدند. برای گروه کنترل، آموزش­های معمول ترخیص از بیمارستان و برای گروه مداخله، برنامه توانبخشی قلبی پرستار هدایتگر به صورت حضوری در منزل و آنلاین در 4 جلسه به مدت یک ساعت و نیم، هفتهای یک­بار و به مدت دوماه پیگیری انجام یافت. ابزار گردآوری داده</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">ها پرسشنامه ویژگی</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">های فردی و بیماری و تبعیت از درمان بود که قبل و سه ماه پس از مداخله برای دو گروه تکمیل گردید. تجزیه و تحلیل دادهها با استفاده از آمار توصیفی</span></span></i><i> </i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">و استنباطی توسط نرم­افزار </span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">SPSS</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""> نسخه 20 انجام گرفت</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="tab-stops:163.05pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">یافتهها</span></span></span></span></i></b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">: </span></span></span></span></i><a name="_Hlk115354100"></a><a name="_Hlk97372822"><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">هر دو گروه از نظر بیش</span></span></i></a><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">تر متغیرهای جمعیت­شناختی با هم همگن بودند <a name="_Hlk153899871">(05/0<</a></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">p</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">).</span></span></i><i> </i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">میانگین و انحراف معیار درصد نمرات تبعیت از درمان قبل از مداخله در گروه مداخله و کنترل به ترتیب 91/7</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span cambria="" style="font-family:">±</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">82/70 و20/11</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span cambria="" style="font-family:">±</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">94/67 بود (015/0=</span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">p</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">). بعد از مداخله به ترتیب به 13/6</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span cambria="" style="font-family:">±</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">10/75 و 12/10</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span cambria="" style="font-family:">±</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">77/68 تغییر یافت و این تغییر از نظر آماری معنا­دار بود (001/0></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">p</span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">)</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">.</span></span></span></span></i></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.1pt">نتیجهگیری: </span></span></span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">نتایج نشان داد که توانبخشی قلبی پرستار هدایتگر در منزل، بر تبعیت از درمان مؤثر است. پیشنهاد میشود که مراقبت­های توانبخشی قلبی به طور مستمر در منزل نیز ادامه یابد. </span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">ثبت کارآزمایی بالینی:</span></span></i></b><i> </i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">IRCT20201006048953N1</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">Background & Aim:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">The main care need of patients with myocardial infarction</span></span> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">(MI) is continuous care, presenting an important challenge in the field of nursing care. Therefore, This study aimed to evaluate the effect of nurse-led home-based cardiac rehabilitation on adherence to therapeutic regimens in patients with MI</span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">Methods & Materials:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">In this randomized clinical trial study, 80 eligible patients were selected through convenience sampling from selected hospitals affiliated with Tehran University of Medical Sciences in 2020-2021. Subsequently, they were randomly allocated to either the intervention or control groups. The control group received routine education upon hospital discharge, whereas the intervention group participated in a nurse-led cardiac rehabilitation program conducted both in-person at home and online, comprising four 90-minute sessions once a week, and were monitored for two months.</span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""> Participants completed socio-demographic and treatment compliance questionnaires before and three months after the intervention. The collected data was analyzed using</span></span> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">descriptive and inferential statistics with SPSS software version 20</span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.1pt">.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt"><span style="layout-grid-mode:line">Results:</span></span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">Both groups were homogeneous in most demographic variables (<i>P</i>>0.05). The mean and standard deviation of treatment adherence scores before the intervention in the intervention and control groups were 70.82±7.91 and 67.94±11.20, respectively (<i>P</i>=0.015). After the intervention, these values changed to 75.10±6.13 and 68.77±10.12, respectively, with a statistically significant difference observed between the two groups (<i>P</i><0.001)</span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt"><span style="layout-grid-mode:line">Conclusion:</span></span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">The results revealed that nurse-led home-based cardiac rehabilitation was effective in enhancing treatment adherence. Therefore, it is suggested that cardiac rehabilitation care be consistently extended to the home setting.</span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">Clinical trial registry:</span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">IRCT20201006048953N</span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt"></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></b></span></span></span></span></span><br>
توانبخشی قلبی, تبعیت درمانی, انفارکتوس میوکارد, پرستاری, کارآزمایی بالینی
cardiac rehabilitation, treatment adherence, myocardial infarction, nursing, clinical trial
393
408
http://hayat.tums.ac.ir/browse.php?a_code=A-10-4518-2&slc_lang=fa&sid=1
Zohreh
Parsaeian
زهره
پارساییان