تاثير دو روش پيگيري تلفني و پيامكي بر زمان پروترومبين بيماران تعويض دريچه قلب در بيمارستان هاي تهران

The effect of two methods, follow-up care by telephone and short message services on prothrombin time in patients with valve replacement surgery in hospitals of Tehran

زمينه و هدف: هدف از درمان هاي ضد انعقادي، حفظ سطح خوني دارو جهت پيشگيري از بروز وقايع ترومبوتيك بدون ايجاد عوارض خونريزي مي باشد. يكي از اركان مهم در مديريت سيستم انعقادي پس از عمل جراحي تعويض دريچه قلب، افزايش آگاهي اين بيماران در مورد داروهاي ضد انعقادي است. هدف از اين مطالعه مقايسه تاثير دو روش پيگيري مراقبتي تلفني و پيامكي بر زمان پروترومبين بيماران پس از عمل جراحي تعويض دريچه قلب مي باشد. مواد و روش ها: اين كارآزمايي باليني بر روي بيماران تحت عمل جراحي تعويض دريچه قلب بستري در بيمارستان هاي منتخب تهران در سال 1390 انجام شد. 99 واحد پژوهش به روش مبتني بر هدف انتخاب و با تخصيص تصادفي در گروه هاي 33 نفري پيگيري تلفني، پيامكي و كنترل قرارگرفتند. پس از تكميل پرسشنامه اطلاعات جمعيت شناختي، زمان پروترومبين واحدهاي پژوهش هنگام ترخيص و 3 ماه بعد از آن ثبت شد. به هر سه گروه قبل از ترخيص كتابچه و آموزش حضوري ارايه شد. درگروه پيگيري تلفني در ماه اول دو بار در هفته و ماه دوم و سوم يك بار در هفته تماس تلفني برقرار شد. در گروه پيگيري پيامكي روزانه يك پيامك ارسال گرديد. به منظور تجزيه و تحليل داده ها از نرم افزار 17 SPSS و آزمون هاي آماري توصيفي، كاي دو ، تي زوجي و آزمون آناليز واريانس استفاده شد. يافته ها: آزمون آناليز واريانس تفاوت معني داري بين ميانگين زمان پروترومبين در گروه هاي پيگيري تلفني، پيامكي و كنترل بعد از مداخله نشان نداد(87/0=P). نتيجه گيري: نتايج نشان داد كه تاثير دو روش در كنترل زمان پروترومبين در بيماران يكسان بود، اما با توجه به اينكه استفاده از روش هاي پيگيري پيامكي كم هزينه و آسان مي باشد، كاربرد اين روش نيز بايد در مراكز درماني قلبي مد نظر قرار گيرد.

Background and Objective: The aim of anticoagulant therapies is maintaining the blood level of drug for prevention of thrombotic accident adverse effects without bleeding. One of the main components in coagulation system management after cardiac valve replacement surgery is to increase patients’ knowledge about thess drugs. after cardiac valve replacement surgery. The aim of this study was to compare the effectiveness of two methods of follow-up: short message service and telephone follow-up care on level of patient’s prothrombin time in patients after cardiac valve replacement surgery.. Materials and Method: This clinical trial study was done on patients admitted for valve replacement in Tehran selected hospitals in 1390 2011. 99 samples patients were selected through purposive samplingbased on the aim of study and then were randomly allocated We considered 33 patients in each groups. They were assigned to into telephone, short message services and control groups. In each group 33 patients were studied. After completing the demographic questionnaire, was completed and patient’s patients’ prothrombin time was recorded measured and recorded at discharge time and 3 months after later.it. The booklet and oral training were presented to all of the participants patients before discharge. Telephone follow-up group were called within the first month twice a week and in the second and third month once a week. One message was sent daily to the patients in Short message services follow-up group were sent one message daily. For analysis of datadata analysis SPSS software17, descriptive statisticals test, Chi-square, paired T-Test and one way ANOVA test were used. Results:: The one way ANOVA test showed no significant difference between the means of prothrombin time in telephone follow-up, , short message services follow-up and control groups after intervention (P=0.87).). Conclusion: Results showed that the effect of two methods in controlling the prothrobin time werewas the same, but according to low cost and easiness of SMS, the application of this method should be considered in cardiac center..According to normal patient’s prothrombin time in each of groups and no significant difference between follow-up care by telephone and short massage services on patient’s prothrombin time after cardiac valve replacement surgery, we will hope to see more usage of easy and low cost follow up care methods in heart’s clinics. Keywords: Follow-up care by telephone, follow-up care by text short messag serviceing, prothrombin time, cardiac valve replacement surgery