تأثیر آموزش خانواده‌محور بر شاخص‌های آزمایشگاهی بیماران پس ‌ازآنفارکتوس حاد میوکارد

نوع مقاله : مقاله پژوهشی

نویسندگان

1 مربی، گروه پرستاری، دانشکدة پرستاری و مامایی، دانشگاه علوم پزشکی اراک، اراک، ایران

2 استادیار، گروه پرستاری مراقبت ویژه، دانشکدة پرستاری و مامایی، دانشگاه علوم پزشکی تهران، تهران، ایران

3 دانشجوی دکتری، گروه پرستاری، دانشکدة پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران

چکیده

اهدافانفارکتوس میوکارد یکی از علل اصلی مرگ و ناتوانی در دنیاست. تبعیت از برنامة درمانی گزینة مراقبتی مهم در این بیماران است؛ لذا، پژوهش حاضر باهدف تعیین تأثیر آموزش خانواده‌محور بر شاخص‌های آزمایشگاهی بیماران پس ‌از آنفارکتوس حاد میوکارد انجام شد.
مواد و روش‌هااین کارآزمایی بالینی از مهر تا اسفند 1393 در بخش مراقبت ویژة قلبی بیمارستان امیرکبیر شهر اراک انجام شد. نمونه‌های پژوهش 60 بیمار پس از بروز اولین سکتة قلبی بودند که بهروش در دسترس انتخاب و به‌طور تصادفی در دو گروه کنترل (آموزش بیمارمحور: 30 نفر) و مداخله (آموزش خانواده‌محور: 30 نفر) قرارگرفتند. در بدو بستری، میزان قندخون و لیپیدهای خون (Chol,TG,HDL,LDL) بررسی شد. سپس، برای گروه مداخله آموزش بیمار به‌همراه عضو فعال خانواده از طریق رایانه در سه حیطة غذایی، دارویی، حرکتی در سه جلسة 30-45 دقیقه‌ای انجام شد. در گروه کنترل همان محتوای آموزشی فقط به بیمار (بدون حضور خانواده) داده شد. سه ماه پس از مداخله، موارد ذکرشده مجدد بررسی شد. در نهایت، تجزیه‌وتحلیل داده‌ها با استفاده آزمون‌های آماری کای دو، تی مستقل انجام شد.
یافته‌هایافته‌ها نشان داد که نتایج درمانی شامل میزان قند خون با 03/0P=، لیپیدهای خون شامل Chol,HDL,LDL,TG با 0001/0 P= در گروه خانواده‌محور اختلاف آماری معنا‌داری با گروه بیمارمحور داشت. این در حالی است که قبل از مداخله، در موارد ذکرشده تفاوت معناداری بین دو گروه وجود نداشت.
نتیجه‌گیریبا توجه به نتایج پژوهش، بهنظر می‌رسد الگوی آموزشی خانواده‌محور بهبود شاخص‌های آزمایشگاهی بیماران دچار انفارکتوس میوکارد را به‌دنبال دارد. لذا، توصیه می‌شود مداخلات آموزشی مربوط به برنامة درمانی در این بیماران با مشارکت خانواده‌ها انجام شود.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Effect of Family-Centered Education on Laboratory Index of Patients after Acute Myocardial Infarction

نویسندگان [English]

  • Parvaneh Asgari 1
  • Fatemeh Bahramnezhad 2
  • Mohammad Golitaleb 1
  • Mokhtar Mahmoudi 3
1 Instructor, Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
2 Assistant Professor, Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
3 Ph.D. Candidate, Department of Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
چکیده [English]

Background & Objectives:Myocardial infarction is one of the main causes of death and disability in the world. Adherence of therapeutic regimen is an important caring option in these patients. This study has been conducted to determine the effect of family-centered education on laboratory index of patients after acute myocardial infarction.
Materials & Methods: This clinical trial was performed between October and March 2014 in CCUward of Amirkabir hospital of Arak. Research samples were 60 patients with 30-70 years old who had been selected by convenience method after the first heart attack and randomly assigned into two groups: control (patient-centered education: 30 individuals) and intervention (family-centered education: 30 individuals). On admission, blood sugar and blood lipids (Chol, TG, HDL, LDL) were examined. Theneducation to patients was done in the intervention group associated with close family member through computers in three domains (diet, pharmaceutical regimen and exercise program) in three sessions of 30-45 minutes and the same educational content were taught to the patient (without family members) in the control group. Three months after the intervention, all aforementioned items were recorded again in two groups and, finally, data were analyzed using independent t-test and Chi-square test.
Results: The results indicated that laboratory indexincluding blood sugar (P=0.03), blood lipids (P=0.0001) in the family-centered group was better than patient-centered group. However, there was not a significant difference between the two groups in aforementioned items before the intervention (P> 0.05).
Conclusion: According to the findings of this study, it seems that family-centered education model improves laboratory index of the patients with myocardial infarction. It is recommended that the educational interventions for the patients with myocardial infarction to be done with the participation of the family.

کلیدواژه‌ها [English]

  • family-centered education
  • laboratory index
  • multimedia software
  • myocardial infarction
[1] Bahramnezhad F, Mohammadi Y, Asadi A, Seif H, Amini M, Shahbazi B. Comparative study on quality of life in patients after percutaneous transluminal coronary angioplasty and coronary artery bypass graft surgery. Iranian Journal of Cardiovascular Nursing, 2012, 1(2).
[2] Bahramnezhad F, Noughabi AAA, Afshar PF, Marandi S. Exercise and quality of life in patients with chronic heart failure. Galen Medical Journal, 2013; 2(2): 49-53.
[3] Sanaie N, Nejati S, Zolfaghari M, Alhani F, Kazemnezhad A. The effects of family-basedempowerment on family cooperation in following patient treatment regime after coroner arteries bypass surgery. Modern Care J., 2014; 11(1): 19-27.
[4] Bahramnezhad F, Asadi NA, Sief H, Mohammadi Y. Quality of life in the patients with coronary bypass graft. 2012.
[5] Babaei M, Mohammad khan Kermanshahi S, Alhani F. Influence of discharge planning on anxiety levels in patient with myocardial infarction. CAB Direct, 2011; 12(3): 272-8.
[6] Laslet L, Alagona P, Clark B, Drozda J, Saldivar F, Wilson S, et al. The wordwide environment of cardiovascular disease: prevalence,diagnosis,therapy,and policy issue: a report from the American college of cardiology. Journal of the American College of Cardiology, 2012; 60(25): 51-549.
[7] Suaya A, Jose S, William B, Ades A, Normand T, Sharon S. Donald cardiac rehabilitation and survival in older coronary patients. Journal of the American College of Cardiology, 2009; 54(1): 712-18.
[8] Scott J, Thompson D. Assessing the information needs of post-myocardial infarction patients: a systematic review. Patient Education and Counseling, 2003; 50(2): 167-77.
[9] Asgari P, Zolfaghari M, Shaabani A. Can addressing Family education improve adherence of therapeutic regimen in hemodialysis patients? A Randomized Controlled Clinical Trial. Nursing Practice Today, 2014; 2(1): 43-9.
[10] Skretteberg PT, Grundvol I, Kjeldsen SE, Erikssen JE, et al. HDL-cholesterol and prediction of coronary heart disease: Modified by physical fitness?: A 28-year follow-up of apparently healthy men. Atherosclerosis, 2012; 220(1): 250-6.
[11] Denhaerynck k, Manhaeve D, Dobbels F, Garzoni D, Nolti Ch, Geast S. Prevalence and consequence of nonadherence to hemodialysis regimens. Ame J Crit Care, 2007; 16(3): 221-36.
[12] Craven RF, Hirnle CJ. Fundamental of nursing. Fifth edition ed: Lippincott Williams & Wilkins, 2007.
[13] Shidfar M, Hosseini MR, Shojaei Zadeh N, Asasi N, Majlesi F, Nazemi S. Effectiveness of an educational program on knowledge and attitudes of an angina patients in mashhad iran:Result of an intervention. Journal of Birjand Universitu of Medical Sciences, 2007; 14(1): 18-27.
[14] Bahramnezhad F, Asgari P, Zolfaghari M, Farokhnezhadafshar P. Family-centered education and its clinical outcomes in patients undergoing hemodialysis short running. Iran Red Crescent Med J., 2015; 17(6): 1-7.
[15] Clary P. Patient empowerment and motivational interviewing: Engaging patients to self-manager their own care. Nephrology Nursing Journal, 2009; 36(4): 410-12.
[16] Madarshahian F, Hassanabadi M, Khazaei S. Effect of holistic cares with family participation on attitude and preoperative anxiety of patients. Medical- Surgical Nursing Journal, 2015; 3(4): 210-8.
[17] Sanaie N, Nejati S, Zolfaghari M, Alhani F, Kazemnejad A. The effects of family-based empowerment on family cooperation in following patient treatment regime after coroner arteries bypass surgery. Modern Care, Scientific Quarterly of Birjand Nursing and Midwifery Faculty, 2014; 11(1): 19-27.
[18] Garrouste-Org, Willems V, Timsit JF, Diaw F, Brochon S, Vesin A, et al. Opinions of families, staff, and patients about family participation in care in intensive care units. J Crit Care, 2010; 25(4): 634-40.
[19] Mohammad Alizadeh Charandabi S MM, Rahmani A, Seidi S, Saffar E, Mahini M, Saghi S. The effect of software on knowledge and performance of teenage girls toward puberty hygiene: a randomized controlled trial. Iranian Journal of Medical Education, 2014; 14(2): 110-21.
[20] Bastable SB Nnep. Urse as educator: principles of teaching and learning for nursing practice. NewYork: Jones and Bartlet, 2003.
[21] Darvish A, Bahramnezhad F, Keyhanian S, Navidhamidi M. The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global Journal of Health Science, 2014; 6(6): 11.
[22] Hosseininasab D, Abdollahzadeh M, Faizollahzadeh H. The effect of computer assisted instruction and demonstration on learning vital signs measurement in nursing students. Iranian Journal of Medical Education, 2007; 7(1): 23-30.
[23] Dilles A, Heymans V, Martin S. Comparison of a computer assisted learning program to standard education tools in hospitalized heart failure patients. Eur J Cardiovasc Nurs., 2011; 10(3): 187-93.
[24] Hausenblas HA, Brewer BW, Van Raalte JL. Development and evaluation of a multimedia CDROM for exercise during pregnancy and postpartum. Patient Educ Couns, 2008; 70(2): 215-9.
[25] Casazza K, Ciccazzo M. The method of delivery of nutrition and physical activity information may play a role in eliciting behavior changes in adolescents. Eat Behav., 2007; 8(1): 73-82.
[26] Feizalahzadeh H, Zagheri Tafreshi, Moghaddasi, Ashgili Farahani, Tayebi Khosrovshahi, Zareh Z, et al. Effect of multimedia based education and traditional method on patient hemodialysis knowledge and treatment adherence. The Journal of Urmia Nursing and Midwifery Faculty, 2014; 12(4): 320-8.
[27] Zolfaghari M, Asgari P, Bahramnezhad F, AhmadiRad S, Haghani H. Comparison of two educational methods [family-centered and patient-centered] on hemodialysis: Related complications. Iranian Journal of Nursing and Midwifery Research, 2015; 20(1): 87-92.
[28] Kjellberg A, Haglund L, Forsyth K, Kielhofner G. The measurement properties of the Swedish version of the assessment of communication and interaction skills. Scandinavian Journal of Caring Sciences, 2003; 17(3): 271-7.
[29] Hoseini M, Rahmani-Nia F, Samami N, Hoseini R. Relationship of nutrition knowledge and physical activity level with total cholesterol, HDL-C and LDL-C in men with myocardial infarction. Cardiovascular Nursing Journal, 2013; 2(3): 26-34.
[30] Ahmadi F, Ghofrani Pour F, Abedi HA, Arefi SH, Faghih Zadeh. The effect of continuous consultation care model on rehospitalization and chest pain in patients with coronary artery disease. The Journal of Qazvin University of Medical Sciences, 2005; 35(9): 99-103.
[31] Najafian J, Rabiei K. Effect of cardiac rehabilitation on ejection fraction and functional capacity of patients with heart failure after myocardial infarction. Urmia Medocal Journal, 2001; 3(12): 220-8.
[32] Koohestani HR, Baghcheghi N, Zand S. Impact of teaching cardiac rehabilitation programs on electrocardiogram changes among patients with myocardial infraction. Journal of Nursing Research, 2010; 5(16): 6-12.
[33] Sanaie N, Nejati S, Zolfaghari M, Alhani FAK. The effect of family-centered empowerment in self efficacy and self esteem in patients undergoing coronary bypass graft surgery. Res Dev Nurs Midwifery, 2013; 11(2): 44-53.
[34] Chien W, Chiu Y, Lam W. Effects of a needs based education programmed for family carrier with a relative in an intensive care unit. International Journal of Nursing Studies, 2006; 43(24): 39-41.
[35] Aggarwal B, Liao M, Allegrate P, Mosca L. Low social support level is associated with non-adherence to diet at 1 year in the family intervention trial for heart health (FIT Heart). Journal of Nutrition Education and Behavior, 2010; 42(6): 381-8.
[36] Vahedian Azimi A, Alhani F, Ahmadi F, Kazemnejad A. Effect of family-centered empowerment model on the life style of myocardial infarction patients. Journal of Critical Care Nursing. 2008; 2(4): 127-32.
[37] Zarkhah S, Ghofranipour FA, Ahmadi F, Doustkami D. Effects of family-centered intervention on dietary patterns in post myocardial infarction. Pejouhandeh, 2011; 11(5): 303-7.
[38] Asgari P, Bahramnezhad F, Zolfaghari M, Farokhnezhad Afshar P. A comparison of the impact of family-centered and patient-centered education methods on attitude toward and adherence to diet and fluid restriction in hemodialysis patients. Medical- Surgical Nursing Journal, 2015; 3(4): 195-202.
[39] Mosavifar A, Zolfaghari M, Pedram SH, Haghani H. The effect of two following methods (mobile and tell) on adherence of theraputice regimen in diabetoc patient. Iranian Journal of Diabet and Lipid, 2011; 10(4): 407-18.
دوره 24، شماره 1
فروردین و اردیبهشت
فروردین و اردیبهشت 1396
صفحه 43-49
  • تاریخ دریافت: 21 خرداد 1395
  • تاریخ بازنگری: 06 فروردین 1395
  • تاریخ پذیرش: 16 مهر 1395
  • تاریخ اولین انتشار: 01 فروردین 1396