تأثير مداخله حمايتي پرستار- همتا محور بر كيفيت زندگي بيماران با دفيبريلاتور داخل قلبي: يك مطالعه كارآزمايي باليني تصادفي شده

THE EFFECT OF NURSE-PEER-LED SUPPORT INTERVENTION ON QUALITY OF LIFE IN PATIENTS WITH AN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR: A RANDOMIZED CLINICAL TRIAL

ﭘﻴﺶﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ :اﻣﺮوزه ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ و ﭼﮕﻮﻧﮕﯽ ﺗﻄﺎﺑﻖ و رﻓﺘﺎر ﺑﯿﻤﺎران ﺑﺎ دﻓﯿﺒﺮﯾﻼﺗﻮر داﺧﻞ ﻗﻠﺒﯽ ﻣﻨﺠﺮ ﺑﻪ اﯾﺠﺎد ﻧﮕﺮاﻧﯽ در اﻓﺮاد اراﺋﻪدﻫﻨﺪه ﺧﺪﻣﺎت ﺑﻬﺪاﺷﺘﯽ- درﻣﺎﻧﯽ و ﺗﻼش ﺑﺮاي ﺗﻘﻠﯿﻞ ﯾﺎ رﻓﻊ ﻣﺸﮑﻼت اﯾﻦ ﺑﯿﻤﺎران ﮔﺸﺘﻪ اﺳﺖ. ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺎﻫﺪف ﺗﻌﯿﯿﻦ ﺗﺄﺛﯿﺮ ﻣﺪاﺧﻠﻪ ﺣﻤﺎﯾﺘﯽ ﭘﺮﺳﺘﺎر- ﻫﻤﺘﺎ ﻣﺤﻮر ﺑﺮ ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ ﺑﯿﻤﺎران ﺑﺎ دﻓﯿﺒﺮﯾﻼﺗﻮر داﺧﻞ ﻗﻠﺒﯽ در ﺑﯿﻤﺎرﺳﺘﺎن ﺳﯿﺪاﻟﺸﻬﺪا اروﻣﯿﻪ اﻧﺠﺎم ﭘﺬﯾﺮﻓﺖ. ﻧﻔﺮ از ﺑﯿﻤﺎران ﺑﺎ دﻓﯿﺒﺮﯾﻼﺗﻮر داﺧﻞ ﻗﻠﺒﯽ ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ درﻣﺎﻧﮕﺎه دﯾﺲ رﯾﺘﻤﯽ واﺟﺪ ﺷﺮاﯾﻂ ورود ﺑﻪ 120 ، ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﮐﺎﺭ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﮐﺎرآزﻣﺎﯾﯽ ﺑﺎﻟﯿﻨﯽ ﺑﻪ ، ﻧﻔﺮي آزﻣﻮن )ﻣﺪاﺧﻠﻪ ﺣﻤﺎﯾﺘﯽ ﭘﺮﺳﺘﺎر- ﻫﻤﺘﺎ ﻣﺤﻮر( و ﮐﻨﺘﺮل )ﻣﺮاﻗﺒﺖ ﻣﻌﻤﻮل( ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. در ﮔﺮوه آزﻣﻮن 60 ﻣﻄﺎﻟﻌﻪ ﺑﻪ روش ﺗﺨﺼﯿﺺ ﺗﺼﺎدﻓﯽ ﺑﻪ دو ﮔﺮوه ﻣﺪاﺧﻠﻪ ﺣﻤﺎﯾﺘﯽ ﭘﺮﺳﺘﺎر- ﻫﻤﺘﺎ ﻣﺤﻮر اﺟﺮا و ﻣﯿﺰان ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ ﺑﯿﻤﺎران ﺑﺎ دﻓﯿﺒﺮﯾﻼﺗﻮر داﺧﻞ 1397 ﺗﺎ اﻧﺘﻬﺎي ﺗﯿﺮﻣﺎه ﺳﺎل 1396 ﻣﺪت ﭘﻨﺞ ﻣﺎه از اﺑﺘﺪاي ﺑﻬﻤﻦ ﻗﻠﺒﯽ دو ﮔﺮوه آزﻣﻮن و ﮐﻨﺘﺮل در زﻣﺎنﻫﺎي ﻗﺒﻞ و ﺑﻌﺪ از ﻣﺪاﺧﻠﻪ ﻣﻮرد ﻣﻘﺎﯾﺴﻪ ﻗﺮار ﮔﺮﻓﺖ. ﮔﺮدآوري دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده ﭘﺮﺳﺸﻨﺎﻣﻪ دوﺑﺨﺸﯽ ﻣﺸﺨﺼﺎت ﺟﻤﻌﯿﺖ و آﻣﺎر ﺗﻮﺻﯿﻔﯽ )ﻣﯿﺎﻧﮕﯿﻦ و اﻧﺤﺮاف ﻣﻌﯿﺎر( SPSS ﻧﺮماﻓﺰار 20 ﺷﻨﺎﺧﺘﯽ و ﭘﺮﺳﺸﻨﺎﻣﻪ اﺳﺘﺎﻧﺪارد ارزﯾﺎﺑﯽ ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ ﻣﮏ ﻧﯿﻮ اﻧﺠﺎم ﮔﺮدﯾﺪ. دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده ﻧﺴﺨﻪ و اﺳﺘﻨﺒﺎﻃﯽ )آزﻣﻮنﻫﺎي ﮐﺎي دو؛ ﺗﯽ ﻣﺴﺘﻘﻞ و ﺗﯽ زوﺟﯽ( ﻣﻮرد ﺗﺠﺰﯾﻪوﺗﺤﻠﯿﻞ ﻗﺮار ﮔﺮﻓﺖ. 83/86 ± 23/45 و در ﮔﺮوه ﮐﻨﺘﺮل 89/10 ± 21/37 ﻳﺎﻓﺘﻪﻫﺎ: ﻣﯿﺎﻧﮕﯿﻦ ﻧﻤﺮه ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ ﻗﺒﻞ از اﺟﺮاي ﻣﺪاﺧﻠﻪ ﺣﻤﺎﯾﺘﯽ ﭘﺮﺳﺘﺎر- ﻫﻤﺘﺎ ﻣﺤﻮر در ﮔﺮوه آزﻣﻮن (؛ اﻣﺎ ﭘﺲ از اﺟﺮاي ﻣﺪاﺧﻠﻪ ﺣﻤﺎﯾﺘﯽ ﭘﺮﺳﺘﺎر- ﻫﻤﺘﺎ ﻣﺤﻮر ﻣﯿﺎﻧﮕﯿﻦ ﻧﻤﺮه ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ P=0/204) ﺑﻮد ﮐﻪ ازﻧﻈﺮ آﻣﺎري ﺑﯿﻦ دو ﮔﺮوه اﺧﺘﻼف ﻣﻌﻨﯽداري ﻣﺸﺎﻫﺪه ﻧﺸﺪ .(P≤0/0001) (ﺑﻪﻃﻮر ﻣﻌﻨﯽداري اﻓﺰاﯾﺶ ﯾﺎﻓﺖ 84/83 ± 27/67( ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﮐﻨﺘﺮل )124/83 ± 10/83در ﮔﺮوه آزﻣﻮن ) ﻧﺘﻴﺠﻪﮔﻴﺮﻱ: ﺑﺮ اﺳﺎس ﯾﺎﻓﺘﻪﻫﺎي ﺣﺎﺻﻞ از ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﭼﻨﯿﻦ ﻧﺘﯿﺠﻪﮔﯿﺮي ﻣﯽﮔﺮدد ﮐﻪ اﺟﺮاي ﻣﺪاﺧﻠﻪ ﺣﻤﺎﯾﺘﯽ ﭘﺮﺳﺘﺎر- ﻫﻤﺘﺎ ﻣﺤﻮر ﻣﯽﺗﻮاﻧﺪ ﺑﻪ ﺑﻬﺒﻮد ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ ﺑﯿﻤﺎران ﺑﺎ دﻓﯿﺒﺮﯾﻼﺗﻮر داﺧﻞ ﻗﻠﺒﯽ ﻣﻨﺠﺮ ﮔﺮدد.

Background & Aims: Nowadays, the quality of life and how coping and treatment of patients with an implantable cardiac defibrillator has led to concern and attempts to reduce or eliminate the problems of these patients in the people who provide health care services. This study aimed to determine the effect of nurse-peer-led support intervention on quality of life in patients with an implantable cardioverter defibrillator in Seyyed-Al-Shohada Hospital in Urmia. Materials & Methods: In this clinical trial study, 120 Patients with an implantable cardioverter defibrillator who had referred to the dysrhythmic clinic and eligible for inclusion of study, were randomly divided into two groups of 60 patients (nurse-peer-led support intervention) and control (routine care). In the intervention group, a nurse-peer-led support intervention was implemented for five months from the beginning of February to the end of July and quality of life rate in patients with an implantable cardioverter defibrillator in the two groups before and after the appalling the nurse-peer-led support intervention were analyzed. Data collection tools included two parts: Demographic characteristics and MacNew quality of life questionnaire. The data were analyzed by SPSS v. 20 and descriptive statistics (mean, standard deviation) and inferential statistics (Chi-square, independent t-test, and paired t-test). Results: The mean score of quality of life before appalling of nurse-peer-led support intervention in the intervention group was 89.10 ± 21.37 and in control group 83.86 ± 23.45 that there was no statistically significant difference between the two groups (P-value= 0.204). But after appalling of nurse-peer-led support intervention, the mean score of quality of life in the intervention group (124/83 ± 10/83) was significantly higher than the control group (84/83 ± 27/67), (P <0.0001). Conclusion: According to the findings of this study, it follows that the appalling of nurse-peer-led support intervention can lead to improving the quality of life of patients with an implantable cardioverter defibrillator.